To: Board of Supervisors
From: Sheriff
Agenda Section: Consent
Vote Requirement: 4/5th
SUBJECT:
title
Sheriff and Probation Appropriation Transfers, Supplemental Budget and Allocation of Program Manager and Program Coordinators for CalAIM Program Implementation (4/5 Vote Required)
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Approve appropriation transfers from the Correctional Facility budget 1100-243 in the amount of $1,396,000 and Juvenile Hall budget 1100-234 in the amount of $760,000 to the Medical Care budget 1100-490 (Attachment 1) to move their respective budgets for CalAIM PATH funding (4/5 Vote Required);
2. Approve a supplemental budget for the Medical Care budget 1100-490 in the amount of $535,594 to utilize additional CalAIM PATH funding in Fiscal Year (FY) 2025-26 (Attachment 2) (4/5 Vote Required);
3. Allocate 1.0 Full-Time Equivalent (FTE) Program Manager (M&C, Class 0934, Range 533) for the Medical Care budget 1100-490; and
4. Allocate 2.0 FTE Program Coordinators (AFSCME, Class 1425, Range 451) for the Medical Care budget 1100-490.
Body
STRATEGIC PLAN:
This action supports the following areas of your Board’s Strategic Plan.
Area of Focus: Safe & Healthy Communities
Strategic Plan Category: 1002- Remove barriers to quality healthcare
DISCUSSION:
The Humboldt County Sheriff’s Office (HCSO) and the Humboldt County Probation Department (HCPD) are collaborating to implement the Justice-Involved (JI) CalAIM mandate in their facilities. The CalAIM mandate is designed to provide pre-release Medi-Cal services to individuals up to 90 days prior to release. This will involve signing up eligible persons for Medi-Cal services as soon as practical upon coming into custody. As incarcerated persons are approaching release, a pre-release care plan will also need to be developed to be referred to community enhanced care managers to establish sound continuity of care practices. With a current population of over 340 adults and approximately 10 juvenile offenders, this workload will be more than existing staff can assume responsibility for. It will require dedicated employees that have a working understanding of the Medi-Cal enrollment and billing processes. HCSO and HCPD are requesting 1.0 Program Manager and 2.0 Program Coordinator positions to manage and perform the work needed to fulfill the state mandate.
PATH JI round 3 grant will provide funding to support the planning and implementation of the provision of targeted pre-release Medi-Cal services to individuals in state prisons, county jails, and youth correctional facilities who meet the eligibility criteria as outlined in the CalAIM Section 1115 Demonstration approval. PATH funds will be available to support investments in personnel, capacity, and/or IT systems that are needed for collaborative planning and implementation in order to effectuate pre-release service processes.
The HCSO was awarded $3,500,000, later adjusted to $1,396,000 which is made available for use in stages, as follows:
• 10% (350,000) within 45 days of award (July 2023) (10% of initial award)
• 60% ($627,200) upon approval of implementation plan (April 2025) (adjusted)
• 15% ($209,400) upon submission of interim progress report (adjusted)
• 15% ($209,400) upon submission of final progress report (adjusted)
The HCPD was awarded $1,500,000, which is made available for use in stages, as follows:
• 10% ($150,000) within 45 days of award (received February 2025)
• 60% ($900,000) upon approval of implementation plan (due July 5, 2025)
• 15% ($225,000) upon submission of interim progress report (due Jan. 15, 2026)
• 15% ($225,000) upon submission of final progress report (due no later than April 1, 2026)
The HCSO and HCPD have both applied for additional funding through the PATH JI round 4 grant that, if approved, would extend funding for an additional 2-3 years for the three positions. Notice of funding approval should hopefully be announced by the end of 2025. HCSO and HCPD are anticipating medical reimbursement revenue that would continue to support the program long-term.
SOURCE OF FUNDING:
CalAIM PATH-JI Grants (1100-490-505053)
FINANCIAL IMPACT:
|
Expenditures |
FY25-26 |
FY26-27 Projected* |
FY27-28 Projected* |
|
Budgeted Expense (1100-243901) (move to 1100-490) |
$1,396,000.00 |
Funds not used in FY25-26 TBD |
TBD |
|
Budgeted Expenses (1100-234) (move to 1100-490) |
$ 760,000.00 |
$204,406.00 plus funds not used in FY25-26 TBD |
TBD |
|
Additional Appropriation Requested (1100-490) |
$ 535,594.00 |
NA |
TBD |
|
Total Expenditures |
$2,691,594.00 |
TBD |
TBD |
*Projected amounts are estimates and are subject to change.
|
Funding Sources |
FY25-26 |
FY26-27 Projected* |
FY27-28 Projected* |
|
General Fund |
$0.00 |
$0.00 |
TBD |
|
State/Federal Funds (1100-243901) (move to 1100-490) |
$1,396,000.00 |
Funds not used in FY25-26 TBD |
TBD |
|
State/Federal Funds (1100-234) (move to 1100-490) |
$ 760,000.00 |
$204,406.00 plus funds not used in FY25-26 TBD |
TBD |
|
State/Federal Funds (1100-490) |
$ 535,594.00 |
TBD |
TBD |
|
Fees/Other |
$0.00 |
TBD |
TBD |
|
Total Funding Sources |
$2,691,594.00 |
TBD |
TBD |
*Projected amounts are estimates and are subject to change.
Narrative Explanation of Financial Impact:
PATH JI round 3 grant will provide funding to support the planning and implementation of the provision of targeted pre-release Medi-Cal services to individuals in state prisons, county jails, and youth correctional facilities who meet the eligibility criteria as outlined in the CalAIM Section 1115 Demonstration approval. HCSO and HCPD have secured funding for 3.0 FTEs for year 1 and have applied for 2-3 years of additional funding to cover the cost of the positions. To effectively manage the grant funding from both agencies, an appropriations transfer request is recommended to move the funds and expenditures from the Correctional Facility budget 1100-243 and Probation’s budget 1100-234 to the county Medical Care budget 1100-490.
At time of budget submission HCPD was unsure of the exact position needs and only budgeted for the 3rd party contracting with Health Management Association with the intent of returning to your Board for a supplemental for the remaining grant funding. Annual salary and benefits for 1.0 FTE Program Manager (Step E) are estimated at $183,378.00. Annual salary and benefits for 1.0 FTE Program Coordinator (Step E) are estimated at $127,617.00 per position. The supplemental request of $156,586.00 for FY 2025-26 reflects six months of salary and benefits for the two positions. It also includes an additional $379,008.00 for Professional Services and software for 3rd party billing for a total of $535,594.00. Any funds not used in FY 2025-26 will be budgeted in FY 2026-27 to support these expenditures. HCPD remaining grant funding of $204,406 is available in FY 2026-27 to support the positions.
At time of budget submission HCSO was unsure of the position vs. 3rd party contracting needs and budgeted their full $1,396,000.00 in the Services & Supplies category. With the recommendation of a second 1.0 Program Coordinator an appropriation transfer is needed to move appropriations from Services & Supplies to Salary & Benefits. Annual salary and benefits for 1.0 FTE Program Coordinator (Step E) are estimated at $127,617.00 per position. Appropriations transfer request of $63,809.00 for FY 2025-26 reflects six months of salary and benefits for the position. The remaining $1,332,191.00 is available to support the below expenditures in FY 2025-26 and FY 2026-27. Any funds not used in FY 2025-26 will be budgeted in the annual budget process for FY 2026-27.
• Billing System Implementation and Technology $196,000.00
• Planning and Consulting $850,000.00
• Screening & Pre-Release $100,000.00
• Salary & Benefits (to help cover the cost of the 3.0 FTE positions along with HCPD’s funding) $186,191.00
Total allocated grant funding from HCPD and HCSO combined for salary and benefits is $610,992.00. Total cost of the 3.0 FTE positions is $438,612.00 per year. HCPD and HCSO have approximately 17 months of dedicated grant funding to cover the 3.0 FTE positions. Both departments have submitted grant applications for an additional 2-3 years’ worth of funding. With the new collaboration of efforts between the two departments, there is the possibility that estimated expenses dedicated for billing, technology, planning, screening and pre-release may be less and therefore modifications to the grant may be requested in the future to provide more funding for the positions. Once the program is up and running, there is medical reimbursement revenue anticipated to help sustain the program and positions.
STAFFING IMPACT:
|
Position Title |
Position Control Number |
Monthly Salary Range (1A-E Step) |
Additions (Number) |
Deletions (Number) |
|
Program Manager |
490-0934-01 |
E |
1.0 |
0 |
|
Program Coordinator |
490-1425-01 & 02 |
E |
2.0 |
0 |
Narrative Explanation of Staffing Impact:
If staffed adequately and developed soundly, this CalAIM JI process is expected to generate significant reimbursements for services currently being provided to those incarcerated. As such, the expected revenue could bring in up to $2-3 million annually, offsetting expenditures that are currently incurred to the County’s General Fund. If true, this would more than offset the cost for these positions. This is only possible if there are dedicated staff to focus exclusively on the work.
OTHER AGENCY INVOLVEMENT:
Humboldt County Probation Department
Humboldt County Administrative Office
California Department of Health Care Services
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may elect not to approve the appropriation transfer, supplemental budget, and allocation of FTEs however this is not recommended. Both the HCSO and HCPD will have mandates under this new program, and without the addition of the FTEs to manage the efforts of implementation and ongoing daily work, it is unlikely that the HCSO and HCPD will be able to meet the mandates and criteria to access the full amount of available funding.
ATTACHMENTS:
Attachment 1 - Appropriation Transfer
Attachment 2 - Supplemental Budget
PREVIOUS ACTION/REFERRAL:
Meeting of: January 23, 2024; May 13, 2025
File No.: 23-1298; 25-562