Board of Supervisors — 2022-10-11

Administrative Agenda Item Pulls

• The Board voted to pull Item A9 regarding the state of emergency and Item A17 regarding Measure A safe routes projects.
• A public speaker opposed the safe routes item, citing concerns about the Bicycle Coalition's financial independence and 501(c)(3) status.
• The motion to remove these two items from the agenda passed with a 4-1 vote.

Administrative Agenda Balance

• The Board reviewed the second amendment to the Contract Law Enforcement Services Agreement with four local cities.
• Discussion focused on the county subsidizing cities with large sales tax bases while unincorporated areas face staffing shortages.
• The Board approved the remaining administrative agenda items unanimously.

Resolution 25: Indigenous Peoples Day

• The Board adopted a resolution proclaiming the second Monday of October 2022 as Indigenous Peoples Day.
• Speakers from the Chumash community discussed the importance of acknowledging Native American history and the stewardship of the land.
• Board members highlighted the county's collaboration with Chumash people on fire management history and the need to confront historical inconsistencies.

Resolution 26: Italian Heritage Month

• The Board adopted a resolution proclaiming October 2022 as Italian Heritage Month.
• Speakers shared personal family histories of immigration and the contributions of Italian Americans to the community.
• The resolution acknowledged the hardships faced by Italian Americans, including internment during World War II.

Supervisor Lavinina’s Announcement: Veterans Stand Down

• Supervisor Lavinina announced the 10th annual Veterans Stand Down event scheduled for October 15 at the Santa Maria Fair Park.
• The event will provide services including healthcare screenings, mental health assessments, clothing, and meals for veterans.
• A donation drive was mentioned to support the event, with contact information provided for the coordinator.

KPMG Operational Performance Review: Department of Social Services

• KPMG identified "Service Delivery Model" and "Data and Reporting" as key areas for improvement, noting that caseload targets are not formalized.
• The department presented responses to nine focus areas, including plans to implement a task management tool and shorten eligibility worker induction training.
• Board members discussed staffing shortages, with the department citing a 19% vacancy rate among Child Welfare Services social workers.
• The Board received and filed the staff recommendation unanimously.

KPMG Operational Performance Review: Department of Behavioral Wellness

• KPMG recommended a CalAIM readiness assessment and the establishment of role-based staff utilization targets to improve performance monitoring.
• The department outlined plans to transition to a Full Service Partnership model and join a statewide initiative for a standardized electronic health record.
• Discussion covered the 29% departmental vacancy rate and strategies to convert locum tenens staff to permanent civil service positions.
• The Board received and filed the report unanimously.

Behavioral Wellness Department: CARE Court Update

• The Director provided an overview of the CARE Act, which establishes civil courts for individuals with severe psychotic disorders, with implementation required by December 2024.
• Estimated annual costs for the county are just under $7 million, with no new state funding currently allocated for behavioral health services.
• Board members discussed the impact on housing options, the lack of private landlord participation, and the financial burden of long-term conservatorship.
• The Board received and filed the report unanimously.

• Meeting Date: October 11, 2022 Location: Santa Maria Hearing Room Body: Santa Barbara County Board of Supervisors

Roll Call and Pledge

• The Clerk called the roll, confirming the presence of all five members: Supervisors Nelson, Lavinina, Williams, Hart, and Chair Hartmann. The Pledge of Allegiance was recited.

Approval of Minutes

• Item: Approval of the October 4, 2022 meeting minutes.
• Action: A motion was made and seconded.
• Decision: Passed unanimously.

Announcements

• The Clerk announced an addendum to the agenda posted on October 7, 2022, adding a Behavioral Wellness Department item regarding CareCorps. The Clerk outlined public participation methods, including in-person attendance (noting face coverings are encouraged but not required indoors), virtual participation via Zoom, and a three-minute limit for public comments.

Administrative Agenda – Item Pulls

• Item A9 (County Executive Office): Recommendations regarding the circumstances of the existing state of emergency.
• Item A17 (Public Works Department): Recommendations regarding a cooperative agreement and construction of Measure A safe routes to school and bicycle and pedestrian projects.
• Public Comment: Scott Wenz, representing "Cars are Basic," spoke in opposition to Item A17, citing concerns regarding the Safe Routes to School program, the financial independence of the Bicycle Coalition, and its 501(c)(3) status.
• Action: Supervisor Nelson requested a roll-call vote to pull the items. Supervisor Lavinina seconded the motion to pull Items A9 and A17.
• Decision: The motion to pull Items A9 and A17 passed 4 to 1.

Administrative Agenda – Balance of Items

• Item A18 (Sheriff/Coroner’s Office): Second amendment to the Contract Law Enforcement Services Agreement between the County and the cities of Buellton, Carpinteria, Goleta, and Solvang.
• Discussion: Supervisor Nelson noted concerns regarding the county subsidizing cities with large sales tax bases while unincorporated areas have unfilled shifts. He stated his intention to move the item forward but emphasized the need for cost-neutral fee-for-service arrangements in future contracts.
• Action: The item was not pulled and proceeded to the vote for the balance of the administrative agenda.
• Action: A motion was made and seconded to approve the remaining administrative agenda items.
• Decision: Passed unanimously.

Resolution 25: Indigenous Peoples Day

• Item: Adoption of a resolution proclaiming the second Monday of October 2022 as Indigenous Peoples Day in Santa Barbara County.
• Discussion: The resolution was read into the record, highlighting the history of the Chumash people, the impact of Spanish missions, and the 1824 revolt.
• Public Comment:
• Reginald Pagolin thanked the board for the recognition and discussed the importance of acknowledging Native American history, mathematics, and science in education, as well as the issue of sacred objects held in museums.
• Eleanor Fishburne (Barbareño Band of Chumash Indians) expressed gratitude and emphasized the ongoing stewardship of the land and culture.
• Supervisor Williams thanked the Chumash representatives and discussed the importance of confronting historical inconsistencies.
• Chair Hartmann noted the county’s collaboration with Chumash people on fire management history.
• Decision: The resolution was adopted.

Resolution 26: Italian Heritage Month

• Item: Adoption of a resolution proclaiming October 2022 as Italian Heritage Month in Santa Barbara County.
• Discussion: The resolution was read into the record, acknowledging the contributions of Italian Americans and the hardships they faced, including internment during WWII.
• Public Comment:
• Larry Lavinino shared the family history of his great-grandfather Augusto, who walked across the Isthmus of Panama, and his father’s career with the Bank of Italy (now Bank of America) in Santa Maria.
• Alfonso Curti thanked the board and shared his personal history of immigrating to Solvang.
• Supervisor Lavinina thanked the speakers and highlighted the immigrant story of hard work and community contribution.
• Decision: The resolution was adopted.

Supervisor Lavinina’s Announcement: Veterans Stand Down

• Supervisor Lavinina announced the 10th annual Veterans Stand Down event scheduled for October 15 at the Santa Maria Fair Park. He detailed the services available (shower, haircut, clothing, mental health assessments, pet care, crisis counseling, healthcare screenings, employment assistance, and meals) and encouraged veterans to attend. He also mentioned a donation drive and provided contact information for the coordinator.

General Public Comment

• Ten speakers addressed the board: 1. Philip Gallanders (New California State): Read a "Declaration of Constitutional Default," asserting that California is in constitutional default and lacks standing as a member state. Chair Hartmann stated her confidence in the county’s elections department. 2. Seth Williams (Old Town Orchid): Spoke in support of the "New California State" movement, citing violations of the U.S. Constitution regarding protection from invasion and domestic violence. 3. Susan Hudspeth / Ravi Levi (New California State): Continued the declaration, describing the movement as establishing a new state with a Republican form of government and listing grievances against the current state government. 4. Revy Levy (SEIU 721): Addressed comments made by the Director of Social Services regarding employee attrition. She argued that the high turnover rate among young women is due to low wages, lack of career advancement, and office culture, rather than the reasons cited by the Director. She noted that the union had sent a letter regarding these comments and was awaiting a response. 5. Lori Lee (Child Welfare Services Social Worker): Described the increased workload and paperwork requirements for social workers over the last 5–10 years. She cited high overtime hours, lack of dedicated after-hours staff, and burnout as primary reasons for attrition, rather than the nature of the work itself. 6. Yuri Gomez (DSS Supervisor): Supported colleagues’ statements regarding attrition. He highlighted that workers leave for better benefits and healthcare affordability, noting that only a small percentage of employees could afford the family health plan prior to recent negotiations. He described the after-hours structure as a continuous night shift rather than on-call. 7. Megan Salas (Eligibility Worker): Stated that she carries a high caseload and that coworker departures negatively impact office morale and workload. 8. Shakara Jones (Child Welfare Services): Questioned the board’s recent experience with frontline work. She described the stress of 24-hour shifts and after-hours duties. She characterized previous comments about attrition as offensive and sexist, asserting that retention issues are due to lack of resources, high caseloads, and low staffing. 9. Benjamin Beach (County Holistic Defense Social Worker): Expressed solidarity with social workers, stating that attrition is driven by pay, benefits, office environment, and lack of advancement opportunities, not pregnancy. 10. Jasmine Mara (Child Welfare Services Social Worker): Described the psychological toll of after-hours duties, including waiting for calls and working extended hours. She reiterated that retention issues are not due to pregnancy or partner careers, but rather the demanding nature of the job and staffing levels.
• Board Response: Supervisor Williams expressed the board’s respect for the work of social workers and commitment to addressing retention issues, emphasizing that the institution should be welcoming to young women, mothers, and fathers. Chair Hartmann thanked the speakers for explaining the pressures they face and acknowledged the emotional demand of the job.

Departmental Item 1: KPMG Operational Performance Review of the Department of Social Services

• Presentation:
• CEO Miyasato introduced the item, noting that DSS is the county’s largest department (15% of the budget) and that the review is part of the "Renew22" initiative. She emphasized that the review is not a financial audit but a management consulting effort to improve efficiency and retention.
• Bill Zizek (KPMG Practice Leader) introduced the KPMG team and noted that the review is the 11th and 12th in a series of departmental presentations.
• Kiva Thornton (KPMG Engagement Leader) outlined the project timeline (August 2021–February 2022) and methodology, which included staff interviews, data analysis, and benchmarking.
• Commendations: KPMG commended DSS for leveraging the CalWIN Business Intelligence Data Warehouse, developing specific training cohorts for eligibility workers, and maintaining virtual operations during the pandemic.
• Key Findings: Using a maturity model, KPMG identified "Service Delivery Model" and "Data and Reporting" as key areas for improvement. Current caseload targets are not formalized, and data analysis relies heavily on institutional knowledge with little written guidance.
• Recommendations: Three main areas were highlighted:
• 1. Workload and Demand Management: Conducting an activity-based workload analysis to develop optimal caseload ranges. KPMG noted significant variation in caseloads (e.g., a 130% difference between the largest and smallest average monthly caseloads in Adult Protective Services). 2. Client Service Delivery: Identification of "high utilizers" (clients with complex needs across multiple departments) and the adoption of additional performance measures to enhance program effectiveness and accountability. 3. Performance Management: Adoption of additional performance measures.
• Department Response:
• Director Nielsen presented the department’s response to the nine areas of focus in the KPMG report:
• Client Service Delivery: The department affirmed its "no wrong door" policy and horizontal integration practices. It noted plans to assess the CalSAS system transition (scheduled for April 2023) for client access improvements and to evaluate the locally funded General Relief program in collaboration with the County Executive’s office during the 2023–24 fiscal year.
• Application and Case Management: The department highlighted the implementation of a task management tool in intake units (June) and a new document imaging system (December). It stated that regional offices have moved to multi-program intake units to strengthen the lead worker model.
• Workload and Demand Management: The department described the use of an "equalizer tool" to spread workloads evenly and daily/weekly assessments by managers to adjust staff assignments based on vacancies and leave. It noted that the new CalSAS system will include an integrated scheduling component.
• Data, Performance, and Outcomes: The department stated it already tracks numerous outcome-based measures and plans to collaborate with other Health and Human Services departments to develop additional cross-departmental measures. It expressed intent to collaborate with the County’s Chief Data Officer.
• Administrative Services: The department noted that the County’s Enterprise Resource Planning (ERP) system, expected to go live in March 2024 (HR module) and Q1 of the next fiscal year (financial module), will replace current labor-intensive tracking systems.
• Learning and Development: The department reported enhancing training for administrative office professionals, with new training to be implemented by July 2023. It noted the completion of the first round of cross-training for economic assistance and employment services and the piloting of Adult Protective Services induction training.
• Succession Planning: The department stated it will use the Countywide learning management system (part of the ERP) to track training. It reported a successful pilot reducing eligibility worker induction training from six months to four months, increasing annual new worker output from approximately 40 to 60.
• Technology: The department is participating in the development of the Health and Human Services Dashboard (functional in the current fiscal year) and a Coordinated Entry System (operational in the next budget year). It is drafting a service level agreement with Central ICT and has ordered docking stations to enable mobile access for field staff by the end of the year.
• Interagency Collaboration: The department is working with the County Executive’s office and other departments to develop technology for assessment, referral tracking, and support across county departments.
• Board Discussion:
• Supervisor Williams asked whether data-driven solutions would fully address workload issues or if staffing levels were sufficient. Director Nielsen responded that while the KPMG-recommended processes are useful, they are most effective when staffing levels are closer to 100%. He cited a 19% vacancy rate among Child Welfare Services social workers (14 vacancies).
• Supervisor Nielsen expressed concern about staffing levels, comparing the situation to the Sheriff’s Department, and asked about strategies to ramp up hiring. Deputy Director Krueger detailed efforts to remove recruitment barriers, including continuous recruitment for master’s-level practitioners, increased bachelor’s-level recruitment, relocation incentives, and retooling the interview process. She noted that 14 people had left year-to-date, 10 had been onboarded, and 7 internal promotions had occurred. Director Nielsen added that the department supports staff pursuing master’s degrees through the Title IV-E program but noted recent losses of graduates to higher-paying employers.
• Supervisor Nielsen asked about the mix of open positions. Deputy Director Krueger stated there were nine master’s-level vacancies and five bachelor’s-level vacancies, noting a statewide shortage of master’s-level practitioners. Director Nielsen mentioned interactions with social work schools regarding program tailoring and noted that some schools were not backfilling waitlists for dropped students.
• Supervisor Nielsen asked about hiring strategies for eligibility workers. Deputy Director Gardner explained a strategy piloted in 2021 to shorten induction training from six months to four months by mixing hands-on and theoretical training from day one. This allowed the department to hire three classes per year instead of two, increasing onboarding capacity by 50%. She noted that CalSAS implementation in April would temporarily pause new hiring cycles to train existing staff, but planning for the next class was underway.
• Supervisor Hart discussed the broader workforce crisis, citing high housing and gas costs as factors affecting retention and recruitment across public and private sectors.
• Supervisor Lavagnino commented on the department’s responsiveness to the KPMG recommendations, noting that the department had not rejected any of the 25 recommendations. He acknowledged the difficulty of the work and the burden of state and federal regulations on frontline workers.
• Supervisor Williams emphasized the importance of introspection and noted that Social Services had been receptive to recommendations. He discussed the value of health benefits in collective bargaining, stating a preference for increased benefits over wage increases, and suggested the County consider operating its own child care facility to support employees.
• CEO Miyasato responded to Supervisor Williams by detailing recent increases in health benefits coverage for employees and their families, noting that the Board had approved higher contributions for the 2023 and 2024 plan years.
• Chair Hartmann asked about retention strategies. Director Nielsen listed various initiatives, including leadership development programs, a tuition reimbursement program (budgeted at $50,000–$60,000 annually), diversity, equity, and inclusion efforts, and monthly "engagement discussions" between supervisors and staff to address needs and support.
• Chair Hartmann asked KPMG to elaborate on the recommended additional outcome measures. KPMG representative Thornton explained that these measures aim to assess program effectiveness in meeting the department’s mission (e.g., community safety, health) beyond regulatory compliance. Examples included tracking the number of children permanently placed in housing, re-entry rates into the system, and long-term utilization patterns to identify "high utilizers" and tailor interventions.
• Motion and Vote:
• A motion was made to receive and file the staff recommendation. The motion was seconded.
• Decision: Passed unanimously.

Departmental Item 2: KPMG Operational Performance Review of the Department of Behavioral Wellness

• Presentation:
• CEO Miyasato introduced the second KPMG report, covering the Department of Behavioral Wellness, which has 404 employees and a $146 million budget.
• KPMG representative Thornton presented the project timeline, noting the review was conducted from April 2021 to January 2022. KPMG commended the department for its multi-year systems change initiative, integration of mental health and alcohol/drug services, reform of documentation processes, implementation of a Tableau dashboard for staff utilization tracking, and expansion of telemedicine services.
• KPMG identified two key areas for improvement: formalizing and communicating utilization targets to staff, and improving the consistency of data communication and flow-down to staff.
• Recommendations:
• 1. CalAIM Readiness Assessment: KPMG recommended a departmental assessment to prepare for the transition from cost reimbursement to CalAIM financing. This includes analyzing utilization, appointment volumes, no-show rates, and staff mix to maximize reimbursement and ensure financial stability. KPMG noted significant progress had been made through Health and Human Services funding allocations. 2. Assertive Community Treatment (ACT) Programs: KPMG noted that the three ACT programs in the county served an average of 89 clients per program per month, below the recommended 100, and that most clients received fewer than the recommended eight interactions per month. KPMG recommended evaluating alternative programs to better tailor service delivery. 3. Staff Utilization Targets: KPMG observed that the department did not have formal role-based utilization targets, using a blanket 60% target instead. The weighted average utilization for FY 2020–2021 was 46%. KPMG recommended establishing role-based targets and implementing a system process for coding unaccounted-for time within the Electronic Health Record (EHR) or Timecode System to better understand time usage.
• KPMG summarized the key takeaway as leveraging existing data to improve performance monitoring and continuous improvement, specifically regarding the tracking of service costs.
• Department Response:
• Director Navarro presented an update on the implementation of recommendations from the KPMG report, which focused on five areas: system of care strategy, financial management, utilization management, staffing and service delivery, and interagency collaboration.
• System of Care Strategy: The department plans to conduct a comprehensive needs assessment and performance review by April 2023 to inform the new three-year Mental Health Services Act (MHSA) plan. A monthly report on high utilizers of services will begin in January 2023 to drive data-based decision-making.
• Financial Management: A grants contract coordinator and new fiscal staff have been hired to track grant utilization and efficacy. The department is preparing for CalAIM readiness, including submitting cost surveys to the Department of Health Care Services (DHCS) and developing a transition plan in coordination with other county departments.
• Utilization Management: Staff are using Tableau and Smartsheet to track time and duties. Training for supervisors and staff on utilization tracking is ongoing. The department is joining a statewide initiative to adopt a standardized electronic health record (EHR) coordinated by CALMESA, with initial deployment anticipated by June 2023 and full implementation expected within two years.
• Staffing and Service Delivery:
• ACT/FSP: The department is moving toward a system-wide Full Service Partnership (FSP) model to increase flexibility and responsiveness for high-utilizer clients. A complete overhaul of criteria and referral systems for these programs is targeted for completion by July 2023.
• Justice-Involved Services: The department is shadowing justice-involved staff to identify inefficiencies and will complete a time study by January 2023 to determine appropriate staffing levels in preparation for Care Court and SB 317.
• Recruitment and Retention: Pay differentials for Psychiatric Health Facility (PUF) staff were implemented in August 2022. A team-based care model in the PUF began in July 2022, with full expansion expected by July 2023. A policy for managing sick time is being developed, with completion expected by January 2023. Collaboration with County HR has streamlined the hiring process, including a 72-hour turnaround for requisition approvals, though a 29% departmental vacancy rate remains. A new quarterly forum has been established where direct staff representatives meet with the executive team to share ideas and concerns.
• Contracts: The department has aligned its contract review process with other county departments, implementing a first-in, first-out protocol. An electronic contract management system is under development.
• Interagency Collaboration:
• Homelessness: The department is enhancing homeless encampment response staffing with new ARPA funds and has submitted an innovation plan to create a housing division focused on retention.
• Criminal Justice: Partnerships with the Sheriff’s Department, Public Defender’s Office, and probation are being strengthened, including a new collaborative for diversion under SB 317 and a real-time housing options dashboard for justice-involved individuals.
• CalAIM Integration: Bi-monthly meetings are held with County Behavioral Health and Public Health to coordinate care, share data, and align with CalAIM incentives.
• Questions and Comments:
• Supervisor Nelson inquired about the status of co-response efforts. The Director stated that a budget is being prepared for a new team covering Santa Maria and Wapato, funded by the Community Corrections Partnership, and that the department is expanding its mobile crisis response system.
• Supervisor Hart asked about the vacancy problem. A KPMG representative noted that this is a national issue and recommended using data and technology to improve processes and reduce administrative burdens.
• Chair Hartman asked about the difference in billing between current methods and CalAIM. The Director explained that current billing is based on cost-per-minute rates, while CalAIM will use state-set rates based on county size and type. This change removes backend audit risks but shifts focus to performance measures and outcomes.
• Chair Hartman asked about the use of locum tenens staff. The Director explained that locums are often used for psychiatrists and nursing staff due to recruitment challenges and higher pay rates, but the department is working to convert them to permanent civil service positions.
• Motion and Vote:
• A motion was made to receive and file the report. The motion was seconded.
• Decision: Passed unanimously.

Departmental Item 3: Behavioral Wellness Department – CARE Court Update

• Discussion:
• The Director provided an update on the Community Assistance Recovery and Empowerment (CARE) Act (SB 1338), which establishes Care Courts.
• Legislation Overview: CARE Court is a civil court that manages petitions for individuals with psychotic disorders (e.g., schizophrenia spectrum) who are experiencing severe disability. It is distinct from Laura’s Law, requiring only six months of outpatient treatment history for eligibility. The court provides counsel, supporters, and mandatory treatment through County Behavioral Health.
• Process: Petitions are assessed within 14 days. If qualified, a care plan agreement is developed within another 14 days. Progress hearings occur every 60 days for up to one year, with a possible one-year extension. Non-compliance may lead to court-ordered medication (which cannot be forced) or evaluation for LPS conservatorship.
• Housing: The legislation relies on existing state housing investments (e.g., No Place Like Home, Project Roomkey) and requires counties to demonstrate a broad range of housing options. Full Service Partnerships (FSP) are expected to be the primary service model.
• Implementation Timeline: The first cohort of counties began implementation. Santa Barbara County must commence no later than December 1, 2024, with a possible extension to 2025 in cases of crisis. There is no opt-out provision. Non-compliance may result in fines of up to $1,000 per day, capped at $25,000 per year per respondent.
• Funding and Costs: No new state funding is currently allocated for behavioral health services; the department expects to use existing MHSA and realignment funds. Medi-Cal reimbursement is expected to cover a portion of costs. Estimated annual costs for Santa Barbara County include approximately $4.6 million for Behavioral Wellness (16 additional staff), $830,000 for the Public Defender’s Office, $480,000 for County Counsel, and $200,000 for the Public Guardian’s Office, totaling just under $7 million.
• Preparation: The department is adding staff to the Assertive Outreach Team (AOT) program, realigning staff in outreach programs, and assessing training needs. Collaboration is ongoing with the Public Defender, Probation, and Public Guardian’s Office. The department is also planning stakeholder education and developing housing options.
• Private Sector Participation and Housing: Supervisor Williams raised concerns regarding the limited willingness of private landlords to accept Section 8 vouchers and the resulting constraints on housing options for individuals with serious mental illness. Williams asked the department head how they would have designed the legislation differently if given the opportunity.
• System Impact and Funding: The department head responded that they would have been more realistic about the impact on the behavioral health system, particularly given limited MHSA funds shared between children’s and adult systems. They noted that while the legislation is effective in engaging individuals in treatment, it creates a growth in system demand. The department head expressed hope that the state will provide additional funding to cover these costs and suggested that broader inclusion of the private sector in the legislation could have helped leverage private insurance dollars for younger adults with private coverage.
• Guardianship and Conservatorship Criteria: Supervisor Nelson inquired about the process for individuals who refuse treatment, specifically regarding guardianship referrals. The department head explained that individuals with untreated psychotic disorders often exhibit anosognosia (lack of self-awareness), which is a symptom rather than mere non-compliance. They clarified that many individuals do not meet the strict criteria for LPS conservatorship (e.g., inability to feed themselves or handle daily decisions), meaning they may be referred for evaluation but ultimately not qualify, allowing them to leave the program.
• Volume and Cost Projections: Supervisor Nelson asked about the projected number of users and the duration of participation. The department head stated that while the initial cohort is estimated at 125 individuals, extensions can last up to two years, potentially increasing the active population to nearly 200 in the second year. The department head highlighted a significant cost concern: individuals placed in long-term care under conservatorship are funded by behavioral health budgets, with the county having paid approximately $9 million in the past year for such costs, a figure expected to grow exponentially.
• CEO Perspective on Housing Funds: The CEO of CSAC noted that while the intent of the legislation is appreciated, there is frustration regarding housing funding. The Governor has indicated that counties should use existing MHSA funds for housing, which creates difficult allocation decisions as Care Court participants may take priority over other eligible individuals.
• Public Comment: Susan Sindelar, a resident, commented that Care Court was designed to address homelessness and that the current fragmented system of care, particularly for substance-induced psychosis, needs improvement. She urged the Board to monitor how funding is allocated and to ensure integrated care for co-occurring disorders, noting that the current system often funnels these individuals into separate alcohol and drug programs rather than integrated care.
• Department Response to Public Comment: The department head acknowledged the comment, clarifying that Care Court is distinct from the AOT program and involves broader changes. They confirmed that the county is currently assessing its programs and funding allocation through a KPMG review to ensure resources are directed to the community’s needs.
• Motion and Vote:
• Supervisor Nelson moved to receive and file the report.
• The motion was seconded.
• Decision: Passed unanimously.

Adjournment

• The meeting was adjourned until October 18th.