LA County Board

11. Acting to Expand Services for the Misdemeanor Incompetent to Stand\nTrial Population\nSubstitute recommendation as submitted by Supervisor Mitchell: Instruct and\nauthorize the Interim Director of Mental Health or the Director of Health\nServices, to be determined upon further discussion with the State Department\nof Health Care Services (DHCS), to accept $100,000,000 in Assembly Bill (AB)\n178 funds and authorize the Interim Director of Mental Health to enter into\nand/or amend any contracts, as necessary, to accept the funds. County\nDepartments are not authorized to expend AB 178 funds unless they meet the\nrequirements, as outlined below, or as stipulated in any agreement by the State;\nand take the following actions: (Continued from the meeting of 1-24-23)\nDirect the Interim County Counsel, in coordination with the Chief\nExecutive Officer, the Director of Health Services, the Interim Director of\nMental Health, the Executive Director of Justice, Care and Opportunities\nDepartment, the Director of the State Department of Health Care\nServices, and/or other relevant parties, to review the Budget Act, AB 178,\nseek State guidance, and ensure any plans developed by the assigned\nDepartments in response to Board Order Nos. 72-E, “Swiftly Creating\nMore Beds for Persons Mentally Incompetent to Stand Trial (MIST) with\nNewly Available State Funding” and 16, “Addressing the Mental Health\nCrisis in Los Angeles County: Developing Mental Health Care Facilities to\nHelp Depopulate the Jail,” from September 27, 2022, comply with the\nBudget Act’s provisions, with the written plans to be shared with the\nBoard before implementation; instruct the Director of Health Services and\nthe Interim Director of Mental Health, in coordination with the Chief\nExecutive Officer, the Interim County Counsel and the Executive Director\nof the Justice, Care and Opportunities Department, to report back to the\nBoard within 30 days with a revised written plan to implement the plans\nrelated to the MIST Funding, that among other things, addresses how the\nMIST Funding and Non-MIST Funding programming plans relate, and the\nInterim County Counsel will confirm in writing that proposed AB 178\nplans comply with the Budget Act;\nInstruct the Director of Health Services and the Interim Director of Mental\nHealth, to implement the revised written plan for MIST funding upon\nconfirmation by the Interim County Counsel that it complies with AB 178,\nand take the following actions:\nDirect the Chief Executive Officer to authorize the Director of\nHealth Services and the Interim Director of Mental Health, to hire,\nconsistent with the revised written compliant MIST plan, via the\nOrdinance Position Authority, and authorize the Director and\nInterim Director to immediately recruit positions utilizing ordinance\nonly positions; and\nAuthorize the Director of Health Services and the Interim Director\nof Mental Health to negotiate and execute Budget Act-compliant\nagreements, consistent with the revised compliant written MIST\nplan, with qualified Mental Health providers to provide acute\nhospital transitional beds to carry out the intent of the Board in\nadopting the plan, where the foregoing delegated authority\nincludes authority to negotiate, on a case-by-case basis,\nappropriate changes to the standard County insurance and\nindemnification provisions, and other standard County contract\nterms;\nInstruct the Director of Health Services and the Interim Director of Mental\nHealth, and other relevant Departments, to report back to the Board in\nwriting in six months after implementation of any AB 178 plan, and\nquarterly thereafter, on key metrics such as the number of MIST or\nnon-MIST beds created, the contracted agencies providing services, the\ndemographics of persons being served, the amount, average length of\nstay, and types of services (e.g. enhanced clinical care, inpatient care,\nmental health stabilization housing and supportive interim housing)\nprovided, the number of clients referred to Department of Mental Health\nIntensive Care Division, Lanterman-Petris-Short conservatorship,\nAssisted Outpatient Treatment, and community-based treatment, and\nfunding balance; and\nInstruct the Director of Health Services and the Interim Director of Mental\nHealth, to report back to the Board in writing in six months, and quarterly\nthereafter, if needed, on sustainable funding sources to support this\nprogram when the one-time funding is expected to be fully exhausted\n(i.e., Fiscal Year 2025-26 under the current plan), with the report to\ninclude strategies to explore all available potential State and Federal\nfunding sources, including ongoing Medi-Cal funding, that will ensure the\nCounty has ongoing funds to carry on at least the same level of services\nfor the program when the current one-time State funding is depleted.\n(23-0326)\nAttachments: Substitute motion by Supervisor Mitchell\nDepartment of Health Services November 18, 2022 Report\nPublic Comment/Correspondence