Sponsor: Social Services
Title
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Grant Agreement with Substance Abuse Mental Health and Services Administration for Mental Health Urgent Care
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Recommendation
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1. Ratify the submittal of the grant application to the Substance Abuse and Mental Health Services Administration for Mental Health Urgent Care.
2. Accept a grant award and approve a grant agreement with Substance Abuse and Mental Health Services Administration for the period upon execution through September 29, 2025, in the amount of $1,000,000 with three additional one-year renewals.
3. Authorize the Chair and Chief Clerk to execute the grant agreement.
4. Authorize the County Manager to execute amendments to the grant agreement in the form approved by the County Attorney’s Office.
5. Authorize the County Manager to enter into agreements and execute amendments to the agreement in accordance with the county’s procurement policies and procedures, provided the amounts are within the limits of grant funding.
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Background and Rationale
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Children and youth who are experiencing a mental health crisis are often unable to find care. Unless they are a danger to themselves or others, they are not assigned to an open bed that may be needed for “critical care” patients. The shortage of beds for those who need intensive care leaves many waiting in the emergency room for hours or winding up in jail.
The 2022 Legislature passed a bill that required the commissioner of human services to establish a pilot project that would address emergency mental health needs for youth who experience a mental health crisis. Ramsey County was given the right-of-first-refusal to receive funding and operate the pilot project.
Ramsey County accepted the pilot project opportunity and has developed a detailed plan of services that will be provided, and the staffing required to provide them, as well as estimated costs for the pilot project.
Proposed services will be provided at 402 University Avenue, a building that currently houses Ramsey County’s crisis services for adults, youth and children. The pilot project will add services targeting African American males ages 13-18 to improve mental wellness by providing timely assessments, triage and supportive interventions that are culturally responsive and family centered. Program staff will partner with family and community members to determine the appropriate level of care and immediate intervention option.
The Minnesota Department of Human Services originally provided $1,000,000 for the pilot project that ran through June 30, 2024; however, this was extended through June 30, 2025. The pilot project will provide an opportunity for the county to determine the level of community need and use of extended services for youth, the demographics of those served and whether the target population is served, and the actual cost of operations. A program evaluation at the close of the pilot project will determine actual revenues and costs and the feasibility of continuing operations without continued grant funding.
In August of 2024, the Mental Health Urgent Care (MHUC) began accepting clients. This was included an extension of hours into the evening and open hours into the evening. It also included a build out of the Children’s Crisis Stabilization Services. The Substance Abuse and Mental Health Services Administration (SAMSHA) grant will help sustain the MHUC pilot.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☒ Opportunity ☒ Accountability
Racial Equity Impact
African Americans are underserved and often experience limited access to mental health programs. The pilot project will not be limited to African American youth but will target this population that experiences disparities in mental health services.
In developing the MHUC Children’s Hospital Shelter data showed that most children served were children of color between the ages of 13-18 and over half were male. Total number of children were 38, these were children that stayed in hospital for overnight stays while not receiving any active mental or medical health care.
Community Participation Level and Impact
Ramsey County staff conducted surveys with parents at schools and community events in Saint Paul during the first quarter of 2023 to determine how much they knew about children’s mental health issues, resources and county services. The survey was distributed in English, Spanish, Somali, Oromo, Hmong and Karen. There were 261 respondents, and most identified as Asian (45%) or Black/African American (24%). Survey results have been used to help design how grant work will be carried out and to inform staff on how to improve connections with parents, expand parents’ knowledge, and increase the children’s mental health resources requested by the community.
Community based providers were also surveyed during the development of the MHUC. Medication management, emergency placements for youth, and stabilization for youth were all gaps that were identified needing to be addressed. The MHUC can address these needs or is in the process of planning to address these needs. Providers also indicated they would be very likely to utilize the MHUC once it was opened.
☒ Inform ☒ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
The SAMHSA grant will provide funding for the Mental Health Supervisor, Peer Recovery Specialist, and 1.5 Full Time Equivalent Mental Health Professionals to provide services at the MHUC. Another large portion of this funding will also support contracts for the MHUC. Currently contracted services necessary for the MHUC include psychiatric services, and security costs. The MHUC is also in the process of expanding the MHUC to provide respite beds to families needing short term respite stays. The funding will also support upgrades in the NextGen documentation system, training for staff and outreach to families. The grant currently is approved for one year, with the opportunity to amend for one-year increments through 2028. Upon completion of grant cycle, the Social Services department will need to add into their budget book the ongoing costs of the MHUC.
The grant requires a one-dollar match for every three dollars provided by SAMSHA. This match is provided in staff costs and contracted services. This will be provided in year one by the Minnesota Department of Human Services pilot grant. After that, this will be budgeted into the operating budget.
Last Previous Action
On June 27, 2023, the Ramsey County Board of Commissioners accepted a grant award and approved a grant agreement with the Minnesota Department of Human Services for a pilot project to expand the Mental Health Urgent Care Facility to provide mental health services for youth in crisis during the period of June 27, 2023, through June 30, 2024 (Resolution B2023-095).
Attachments
1. Notice of Award Letter