TITLE:
title
AUTHORIZATION TO SUBMIT A JOINT APPLICATION WITH THE COUNTY TO THE STATE FOR BEHAVIORAL HEALTH BRIDGE HOUSING FUNDS TO INCREASE CAPACITY AND IMPLEMENT BEHAVIORAL HEALTH CARE AT THE BRIDGE SHELTER
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DEPARTMENTS: CITY MANAGER’S OFFICE
PRESENTED BY: NATE ROBBINS, NEIGHBORHOOD IMPROVEMENT MANAGER
CONTACT INFORMATION: NATE ROBBINS, NEIGHBORHOOD IMPROVEMENT MANAGER, (714)754-5274
RECOMMENDATION:
recommendation
Staff recommends the City Council:
1. Authorize submission of an application with the Orange County Health Care Agency to the California Department of Health Care Services for Behavioral Health Bridge Housing Program funds to increase capacity at the Bridge Shelter by adding 15 behavior health beds and associated services for individuals with Serious Mental Illness (SMI) or Substance Use Disorder (SUD), and appropriate all awarded funds to the Housing Authority’s Shelter Budget.
2. Authorize the City Manager or her designee to execute agreements and amendments to agreements to bring the Bridge Shelter Behavioral Health Project to fruition.
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BACKGROUND:
Costa Mesa Bridge Shelter
In March 2019, the City Council approved the purchase and renovation of the building located at 3175 Airway Avenue as the future location of the Costa Mesa Bridge Shelter. While the entire building consists of over 27,000 square-feet of floor space, the Bridge Shelter currently occupies one-half of the building (Unit B), with the other half of the building (Unit A) being leased by the City to a local business.
In November 2020, the cities of Costa Mesa and Newport Beach (“Cities”) entered into a Memorandum of Understanding (MOU) to share the costs of developing and operating the then 72-bed Bridge Shelter. Later, in June 2023, the MOU was amended to increase Shelter capacity to 88 total beds. As a result, 25 of the Shelter’s beds were set aside for exclusive use by Newport Beach clients, 60 beds were allocated for exclusive use by Costa Mesa clients, as well as three (3) beds for emergency use by both Cities.
The Bridge Shelter serves over 200 individuals each year and has an annual operating cost of approximately $2.7 million.
Recent State Legislation
On August 31, 2022, Senate Bill 1338 (SB 1338) was passed into law enacting the Community Assistance, Recovery, and Empowerment (CARE) Act, which authorizes the creation of a voluntary CARE agreement, or a court-ordered CARE plan, and implements services to provide behavioral health care to adults diagnosed with Serious Mental Illness (SMI) and/or Substance Use Disorder (SUD).
Behavioral Health Bridge Housing Program
On September 6, 2022, Assembly Bill 179 (AB 179) was signed into law authorizing amendments to the Budget Act of 2022. Included in the amendments was the creation of the Behavioral Health Bridge Housing (BHBH) Program via reallocation of $1.5 billion to the Department of Health Care Services (DHCS) for allocation to counties to support planning, implementation and infrastructure costs for the CARE Act. The primary focus of the BHBH Program is to assist individuals experiencing homelessness who have serious behavioral health conditions that prevent them from accessing resources and securing permanent housing.
On February 24, 2023, the DHCS released a Request For Applications (RFA), which made available $907 million to the 58 county Behavioral Health Agencies in California, including up to $31.6 million available to the Orange County Health Care Agency (OCHCA).
The OCHCA has expressed interest in collaborating with the City of Costa Mesa (City) to provide behavioral health care and housing for individuals diagnosed with SMI and/or SUD by increasing capacity at the Bridge Shelter and incorporating on-site behavioral health services.
ANALYSIS:
Behavioral Health generally refers to the effect of one’s behaviors and emotions on their overall well-being, with a specific focus on mental health and substance use disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 20% of adults in the U.S. have a clinically significant mental health or substance use disorder. Further, as identified in the 2022 Point In Time (PIT) Count, of the 4,996 adults experiencing homelessness in Orange County, 33% (1,633 people) reported struggling with substance use and 29% (1,445 people) were diagnosed with a mental health disorder. As seen in the statistics above, mental health and substance use disorders affect all people regardless of housing status, yet many people fail to receive treatment due to the cost and scarcity of behavioral health services.
While the City has a comprehensive system of care for those experiencing homelessness, one of the last remaining gaps is the provision of behavioral health services. The absence of high-quality behavioral health care means barriers to employment and housing remain unaddressed, which significantly reduces a client’s chances of securing and retaining permanent housing.
The BHBH Program provides funding to expand infrastructure and services to augment the behavioral health system for those diagnosed with SMI and/or SUD. Specifically, the BHBH Program provides formula grant funding for the creation and ongoing operation of permanent or interim housing units, coupled with wrap-around behavioral health services. Approved BHBH projects are eligible to receive up to $75,000 per behavioral health bed created, as well as annual operating subsidies for the provision of supportive services. Funding of up to $75,000 annually per BHBH bed are available upon the activation of behavioral health beds and guaranteed until June 30, 2027. Therefore, after June 30, 2027, the City will need to reapply or locate other sources of funding. At this time, there is no additional funding identified in the State BHBH Program past June 30, 2027. However, staff’s belief is that providing these much needed services to clients at the Bridge Shelter for the grant funding period would significantly increase outcomes and help to reduce homelessness for those in the program over the next four years.
Project Overview
The Bridge Shelter Behavioral Health Project (Project) contemplates the creation of 15 new behavioral health beds and the provision of associated services within the Shelter’s existing footprint. If approved and upon completion, the Bridge Shelter’s capacity will increase from 85 to 100 total guests with specialized behavioral health services available for as many as 15 guests diagnosed with SMI and/or SUD. The three emergency beds currently available at the shelter for quarantine and other purposes would remain as is.
Project Budget - Capital Improvements
The BHBH Program provides one-time capital grant funding up to $75,000 per bed to expand the behavioral health infrastructure. Upon the activation of the BHBH Program, the program grant also provides up to $1,125,000 for any capital costs associated with these 15 behavioral health beds. The capital improvements required to add these 15 BHBH beds includes the beds, lockers, and the installation of divider extensions over existing pony walls that are adjacent to bunk beds. There may also be certain modifications needed for the restrooms, kitchen or dining areas; however, major construction is not needed as the bridge shelter is already built to accommodate 100 beds. No additional City funding would be needed to build out these 15 additional beds.
Project Timeline
The Project requires only minor improvements to the existing dorms; thus, the 15 behavioral health beds are anticipated to be available for occupancy within twelve months of an award of BHBH Program funds. Any other capital improvements will have no effect on the timing in which the 15 BHBH beds will be available for occupancy as they would be focused on improving quality of life for guests (i.e. HVAC, kitchen upgrades, dorm upgrades, etc.).
Project Budget - Shelter Operations
The BHBH Program provides ongoing operating subsidies for the provision of shelter services to individuals occupying a BHBH bed. Unlike the formula grant utilized to determine one’s award of capital funds, operating funds are negotiated based on the actual costs associated with operating the BHBH beds. At a later date and contingent upon both City Council approval and an award of BHBH Program funds, an MOU with the OCHCA will be executed for an annual award of approximately $570,000 to offset the cost of operating the new 15 Behavioral Health beds. This amounts to an estimated $38,000 per BHBH bed. Per State guidelines, the funding would begin upon activation of the BHBH beds, which is projected at February of 2024, and funding would expire on June 30, 2027. The City will need to identify a structural ongoing source of funding after this date in order to continue offering on-site behavioral health care. The County has expressed a verbal commitment to work with the City to help secure grants and other funding sources to help offset future costs once this funding expires. Further, additional rounds of BHBH funding are anticipated, but not guaranteed, to be made available for both new and previously approved projects.
Shelter Operations
It is anticipated the Project would have little effect on the day-to-day operations of the Bridge Shelter. However, while the City will maintain control over nearly all aspects of the guest selection process, CARE Court participants referred to the Bridge Shelter will receive first priority for entry into the Program, regardless of city of origin for the 15 BHBH beds. Further, beds that are unable to be filled by local clients must be made available to non-Costa Mesa/Newport Beach residents experiencing homelessness within the Central Service Planning Area (SPA). Any vacated bed due to a permanent housing placement will, once again, be made available for occupancy by a Costa Mesa/Newport Beach client, assuming no CARE Court participant is on a waiting list for placement.
Mental illness and substance use pose significant barriers to accessing services, including emergency shelter. As a result, many individuals suffering from SMI and/or SUD are unable to thrive in a shelter setting absent behavioral health care. The grant funds allow the opportunity for local providers to coordinate on-site delivery of behavioral health services, thus rendering the Shelter a more viable option for many who may have never accessed the resource. Further, current guests of the Shelter diagnosed with SMI and/or SUD will be transitioned to a BHBH bed, which will decrease the rate of recidivism and greatly improve the likelihood of guests achieving a positive outcome.
The Behavioral Health Care Project provides an opportunity to increases overall Shelter capacity by 15 beds at little to no cost to the City, expands the Shelter’s service model to make the resource available for a broader range of unsheltered clientele, and augments services available to current guests who may otherwise have left their behavioral health conditions untreated.
ALTERNATIVES:
The City Council can deny staff’s request, which would result in the Shelter’s capacity being maintained at 88 beds without the availability of on-site behavioral health services.
FISCAL REVIEW:
As mentioned previously, the BHBH Program provides ongoing funding for the provision of shelter and behavioral health services to individuals occupying a BHBH bed through June 30, 2027. Thereafter, the City can apply for BHBH Round 2 funds and/or work with the County to identify an alternative source of funding to continue offering specialized behavioral health care to Bridge Shelter guests. If no other funding source were available, the City could still help individuals in need of these services over the next four years which is a worthwhile endeavor.
LEGAL REVIEW:
The City Attorney’s office has reviewed this report and approved it as to form.
CITY COUNCIL GOALS AND PRIORITIES:
This item supports the following City Council Goals:
• Diversify, Stabilize and Increase Housing to Reflect Community Needs
• Strengthen the Public’s Safety and Improve the Quality of Life
CONCLUSION:
Staff recommends the City Council:
1. Authorize submission of an application with the Orange County Health Care Agency to the California Department of Health Care Services for Behavioral Health Bridge Housing Program funds to increase capacity at the Bridge Shelter by adding 15 behavior health beds and associated services for individuals with Serious Mental Illness (SMI) or Substance Use Disorder (SUD), and appropriate all awarded funds to the Housing Authority’s Shelter Budget.
2. Authorize the City Manager or her designee to execute agreements and amendments to agreements to bring the Bridge Shelter Behavioral Health Project to fruition.