HomeMy WebLinkAbout03 Mental Health Grant Supplemental Request1
Budget Supplemental Request
For increases above budgeted revenues or expenditures; new or increased programs, services, or personnel;
transfers over $50,000; or transfers across funds.
Project/Service Name: HCPF Grant for
Be Well: Mental Health Systems Coordination Work Session Date: August 8, 2017
Department: Public Health Budget Year: 2017
Request Type: Adjustment to Operations Adjustment Type: One-Time Adjustment
Fund: Public Health
Staff Responsible: Karen Koenemann Prepared By: Karen Koenemann
Budget Staff Review - Name: Connie Baker Date: 8/2/17
1) PROJECT DESCRIPTION AND FISCAL IMPACT:
The 2013 Pitkin County Public Health Improvement Plan identified Mental Health and Substance Use (hereafter “Mental
Health”) as one of the top health issues to address. The 2016 Public Health Community Needs Assessment has found
that Mental Health and Substance Use Disorders are continuing to grow. Suicide is the fourth leading cause of death in
Pitkin County, as compared to the State, where it ranks seventh. A Mental Health System gaps/assets assessment was
conducted in 2016, and through the assessment, it was determined that although there were many resources across the
community, the overall System was fragmented. Residents within the System struggle to smoothly move within the
Mental Health Continuum of Care (Prevention, Intervention, Treatment and After-Care) providers are challenged to
connect residents to the programs/services which would best serve their need, crisis care organizations are wrestling
with turf issues, and there is a perception with residents of the community that organizations are not responding
adequately to the Mental Health crisis and the 2016 Pitkin County Community Survey results showed that citizens do
not feel the County is doing enough to address these issues.
Although there are a range of high quality Mental Health programs/services within the County, the Mental Health
System is fragmented. There are very few clinical providers who accept Health First Colorado Insurance (Colorado’s
Medicaid Provider), limiting choice and access. Currently, there is a wait-list for first time clients trying to access
outpatient counseling services. Referral systems and warm-handoffs between organizations are also fragmented and
clients moving along the Continuum of can fall through the cracks. A comprehensive approach to addressing
population-level Mental Health concerns for low-income and vulnerable populations in Pitkin County entails focusing on
the overall System of Care.
In response to the above issues, a group of local funders (Law Enforcement, Aspen Valley Hospital, City of Aspen,
Aspen Ski Company, Colorado Mountain College, Aspen Community Foundation, Pitkin County Human Services, Pitkin
County Public Health) were gathered as a steering committee in October 2016 to determine interest in a collective
funding for collective impact approach by combining both charitable and contract funding for Mental Health. A series of
strategic planning meetings were convened throughout the winter, and a Strategic Initiative Team Charter was created
with a goal of creating a comprehensive approach to addressing population-level Mental Health issues with an
overarching goal of creating a system of care change that rapidly improves access to mental health programs/services
for Pitkin County residents by defining funding methods and applying financial resources to support programs that
reflect system of care priorities, provide needed services and demonstrate collaboration.
From these meetings, the group concluded with unanimous approval to work together to create a community Request
for Proposals for the range Mental Health programs/services along the Continuum. Four of the entities, Aspen School
District, Pitkin County, City of Aspen and Aspen Valley Hospital all agreed to enter into an Intergovernmental Agreement
(IGA) for Pitkin County to serve as the Fiscal Agent for this shared effort.
After studying other County’s efforts (Jefferson, Summit, El Paso) across the state which have identified similar
struggles with their Mental Health System, we learned that many communities are taking the lead on addressing this
issue through a variety of strategies, including the one we are proposing below.
To oversee this effort and help with community collaboration, we propose the Be Well Initiative. The Initiative will focus
on hiring a contracted Mental Health Systems Coordinator through an RFP process, who will be responsible for building
collaborations between organizations to reduce fragmentation and influence long-term mental health for our most
vulnerable residents. One of the first tasks will be to manage the roll-out of the collaborative funding effort of public
dollars from the Aspen School District, City of Aspen, Pitkin County and Aspen Valley Hospital to help support
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organizations willing to collaborate with each other along the Mental Health Continuum of Care. The selected
contractor’s work will include managing organizations selected through the Request for Proposals process to provide
Mental Health programs/services. This will entail managing contracts, creating shared working agreements (MOU’s),
coordinating organization’s efforts with other community partners, including referral systems, assisting with the
development of metrics, and holding contractors accountable. This person will also manage the IGA’s with the collective
funders. Additional duties are included in the RFA.
In partnership with Public Health, Human Services applied for a Department Health Care Policy and Finance grant to
cover 40% of the proposed $50,000 budget, for a one-year contract (July 1, 2017-June 30, 2018), and were awarded.
We will be using Administrative Strategic Initiatives funds to support 25% of the contract in SFY 2017-2018. We will be
asking our current strategic funding partners to help support the contract work in SYF 2018-2019. The Contractor will be
asked to create a long-term sustainability plan for this work moving forward after SYF 2018-2019.
This supplemental request appropriates half of the grant for the remainder of calendar year 2017. The other half of the
grant will be included in the 2018 Public Health budget.
2) STRATEGIC PLAN GOAL(S) ADVANCED:
Livable and Supportive Community, Prosperous Economy
3) REQUESTED EXPENDITURE APPROPRIATIONS: Full Cost of Project
Line Item Description
Account Coding
Original
Budget
Amount
Expenditure
Increase/
(Decrease)
Total Adjusted
Budget
Mental Health Coord. Contract (1/2 yr) 124.84.94840.82009 $0 $23,400 $23,400
Routine Travel (1/2 yr) 124.84.94840.82640 $0 $1,109 $1,109
Manager’s Strategic Initiatives 001.23.95026.82000 $40,000 -$12,646 $27,354
Transfer to Public Health Fund 001.00.00000.97124 $470,488 $12,646 $483,134
Total New Appropriations $24,509
4) FUNDING
NEW REVENUE APPROPRIATIONS:
Line Item Description
Account Coding
Original Budget
Amount
Revenue
Increase/
(Decrease)
Total Adjusted
Budget
HCPF Grant (1/2 yr) 124.84.94840.62356 $0 $11,863 $11,863
Transfer from General Fund 124.00.00000.95001 $470,488 $12,646 $483,134
Total New Revenue $24,509
USE OF PUBLIC HEALTH FUND BALANCE: $0
Total Funding $24,509
5) NET CHANGE TO FUND BALANCE
Total Public Health Fund Balance projected at 12/31/2017 $152,881
Use of Fund Balance $0
Public Health Fund Balance after Supplemental Request $152,881
Total GF Unassigned Fund Balance projected at 12/31/2017 $3,787,359
Use of Fund Balance $0
GF Unassigned Fund Balance after Supplemental Request $3,787,359
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6) ALTERNATIVE ANALYSIS
If Pitkin County chose to not to approve the HCPF funding for the Mental Health System Coordinator Contractor, the funds
would be returned to HCPF and the Contractor would not be hired. The perception that the County was not adequately
addressing the Mental Health crisis might persist. Fragmentation within the Mental Health System of Care may remain.
Community members may continue to fall through the cracks along the Continuum of Care.
BOCC Approval: _________ ____________________________________
Date County Manager Signature
For Budget Department Use:
TRANSACTION # DATE ENTERED