To: Board of Supervisors
From: DHHS: Behavioral Health
Agenda Section: Time Certain Matter
SUBJECT:
title
10:00 AM - Presentation on Department of Health and Human Services - Behavioral Health Sempervirens
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RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Receive the Providence St. Joseph Hospital Humboldt County presentation on 5150 Impacts to Local Emergency Departments;
2. Receive the Department of Health and Human Services - Behavioral Health’s presentation on Sempervirens, services, structure and community mental health crisis response; and
3. Discuss potential grant funding for staff to support patients showing signs of mental health crisis in emergency departments, and options for its use.
4. Direct the Department of Health and Human Services on next steps to take regarding potential funding.
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SOURCE OF FUNDING:
Behavioral Health Fund
DISCUSSION:
5150 is the number of the section of the Welfare and Institutions Code which allows a person with a psychiatric crisis to be involuntarily detained for a 72-hour psychiatric hospitalization. Individuals in psychiatric crisis are taken to local hospital emergency departments to be medically cleared prior to assessment and potential admission to Sempervirens, a sixteen bed, acute psychiatric hospital licensed by the California Department of Health Care Services and administered by the Department of Health and Human Services (“DHHS”) Behavioral Health (“BH”) Branch.
Practice changes made prior to and during COVID regarding medical clearance along with an increase in those presenting in mental health crisis and a lack of adequate placement resources statewide, have strained behavioral health crisis care, with impacts on local hospitals, law enforcement, DHHS, clients and the overall community. Presentations by Providence and DHHS on the impact of psychiatric crises/5150s on emergency departments and Sempervirens will provide background and context for your Board.
DHHS-BH has implemented Mobile Response Teams (“MRT”) to respond to psychiatric crises in the field, de-escalate when possible, and release 5150 holds when appropriate. Attempts to hire additional staff for MRTs have not been consistently successful, reflecting the continuing trend of unavailability of licensed, clinical providers, compounded by very competitive wages offered by private employers. DHHS-BH has pursued grant funding for behavioral health staff to support individuals in crisis, prior to, or who do not meet criteria for, admittance to Sempervirens. DHHS is seeking the direction of your Board in how to use the approximately $200,000 that is available for this purpose. Decisions to be made include: whether to share funding with local hospitals; if yes, how to determine sharing ratios with local hospitals; how to ensure funding meets community need and grant requirements (including necessary tracking); and, how to ensure that the funding is not used by external partners to meet their own regulatory mandates.
FINANCIAL IMPACT:
DHHS submitted applications to the California Department of Health Care Services for Mental Health Block Grants designed to address the needs of individuals presenting with a First Episode of Psychosis. This funding has been approved for approximately $200,000. Decisions made by your Board will determine whether DHHS-BH should allocate this awarded funding to hospitals or keep it internally to use for these services. If the recommendation is to allocate it to the local hospitals, DHHS requests direction on how to successfully utilize the funds to meet the grant requirements.
STRATEGIC FRAMEWORK:
This action supports your Board’s Strategic Framework by providing community appropriate levels of services, protecting vulnerable populations, and creating opportunities for improved health and safety.
OTHER AGENCY INVOLVEMENT:
N/A
ALTERNATIVES TO STAFF RECOMMENDATIONS:
Board Discretion
ATTACHMENTS:
None
PREVIOUS ACTION/REFERRAL:
Board Order No.: N/A
Meeting of: N/A
File No.: 22-584