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HomeMy WebLinkAboutAgenda 10-07-2025; 8-q - Approval of Budget Amendment #2-A to Fund the Mobile Crisis Team Pilot (CARE) with Grant Funding Awarded to Alliance Healthcare ORD-2025-032 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date:October 7, 2025 Action Agenda Item No.8-q SUBJECT: Approval of Budget Amendment #2-A to Fund the Mobile Crisis Team Pilot (CARE) with Grant Funding Awarded to Alliance Healthcare DEPARTMENT: Emergency Services, County Manager ATTACHMENT(S): FY 2025-26 Alliance Health Budget Form Expansion August 22, 2025 Memorandum from NCDHHS Year-To-Date Budget Summary INFORMATION CONTACT: Caitlin Fenhagen, 919-245-2303 Kirby Saunders, 919-245-6123 Kim Woodward, 919-245-6133 PURPOSE: To approve Budget Amendment # 2-A to provide grant funding for an additional year and expansion of the Mobile Crisis Pilot – the Crisis Assistance, Response and Engagement (CARE) Team – in collaboration with Alliance Healthcare and the Town of Chapel Hill. BACKGROUND: The CARE Team is a three person mobile unit that responds to 911 and crisis calls in lieu of law enforcement or emergency medical services (EMS). The mobile team includes a crisis counselor, a peer support specialist and an emergency medical technician (EMT). The mobile team is complemented by a fourth position, a crisis counselor who is embedded in the 911 Call Center. The CARE Team is a collaboration between Orange County and the Town of Chapel Hill. The Pilot started operation in May 2024 under the direct supervision of the Chapel Hill Police Crisis Division, and with joint oversight by leadership at the Chapel Hill Police Department Crisis Division, Orange County Emergency Services, County EMS and the Criminal Justice Resource Department. Alliance Healthcare provided start-up costs for the CARE Team in FY 2023-24 and sought and received a grant from the N.C. Department of Health and Human Services (NCDHHS), Divison of Mental Health, Developmental Disabilities and Substance Use Services, for Orange County in the amount of $579,500 for FY 2024-25. The CARE Team’s coverage was limited to Chapel Hill calls and the hours of operation were from 8:00am to 4:30pm. In FY 2024-25, the CARE Team responded to 1,040 events and served 349 unique individuals. 93% of the responses did not result in any criminal charge. Only 5% of the responses required transport to a hospital for a medical emergency, and only 7% required transport to a hospital for behavioral health care. Orange County and the Town of Chapel Hill requested expansion funding for FY 2025-26 that would allow the CARE Team to provide coverage to Carrboro and and extend the service hours. 1 Carrboro separately funded a crisis counselor position to suport the CARE team for this potential expansion.The request submitted to Alliance Healthcare and NCDHHS sought funding for three (3) new positions to provide for a second mobile team to serve from late afternoon until late at night on weekdays. On August 22, 2025, Alliance Healthcare notified Orange County that NCDHHS had allocated $790,640 to Alliance Healthcare for the CARE Team’s expansion (see attachment). On September 4, 2025, the CARE Team expanded its operation to Carrboro. Hiring is underway to fill the new positions in order to expand the coverage hours. FINANCIAL IMPACT: This grant provides Fiscal Year 2025-26 funding of $790,640 to support and expand the Mobile Crisis Team. The additional funding supports the existing Crisis Counselor contract with the Town of Chapel Hill and the County’s Crisis Response Community EMT, therefore reducing the General Fund appropriation by $173,298. This grant also expands the Mobile Crisis Program by providing for an additional full-time equivalent (FTE) position with the County, two additional FTE positions through a contract with the Town of Chapel Hill staff, and additional operational costs. Budget Amendment #2-A reduces the General Fund appropriation by $173,298 and updates the following grant ordinance in the Multi-Year Grant Fund, outside of the General Fund by $790,640. DHHS Care Grant ($790,640) - Project # 71501 Revenues for this project: Current FY 2025-26 FY 2025-26 Amendment FY 2025-26 Revised Grant Revenue $579,500 $790,640 $1,370,140 Total Project Funding $579,500 $790,640 $1,370,140 Appropriated for this project: Current FY 2025-26 FY 2025-26 Amendment FY 2025-26 Revised Expenditures $579,500 $790,640 $1,370,140 Total Costs $579,500 $790,640 $1,370,140 ALIGNMENT WITH STRATEGIC PLAN: This item supports:  GOAL 2: HEALTHY COMMUNITY OBJECTIVE 1. Improve harm reduction, prevention, and support services for adults and children experiencing behavioral health issues, substance use disorder, and intellectual or developmental disability. OBJECTIVE 2. Expand access to quality, affordable healthcare services. (e.g., Crisis Diversion facility, Medicaid expansion, crisis response, healthy living campaign). OBJECTIVE 3. Provide social safety net programming and the resources needed for our most vulnerable community members (e.g., veterans, unhoused people, foster children, older adults, etc.). OBJECTIVE 4. Reduce impacts and barriers for justice-involved children and adults through deflection, diversion, therapeutic interventions, and re-entry support, including housing. OBJECTIVE 5. Invest in, support, train, and retain our community safety, health, and emergency services employees and direct care workforce. 2 OBJECTIVE 6. Provide sustainable, equitable, and high-quality community safety and emergency services to meet the community’s evolving needs. OBJECTIVE 7. Invest in services and programs that improve the health and quality of life of the community (e.g., recreation and public open spaces, arts, etc.) RECOMMENDATION(S): The Manager recommends that the Board approve Budget Amendment #2-A to include $790,640 in a Multi-Year Grant Fund to support the existing and expansion funding for the Mobile Crisis Team Program. The Town of Chapel Hill will invoice Orange County for payment of its share of the individual and joint expenses, and Orange County will provide copies of invoices, payroll, and all expenses to Alliance Healthcare to ensure funds are being used for allowable expenses. 3 Provider Name Orange County Program Name CARE Team Please provide explanations and justifications for budget expenses below: Budget Line Item Description Explanation and Justification Travel/Staff Lodging/Meals Funding for conferences and training opportunities involcing travel. Client Assistance Activities Funding for basic needs including snacks, clothes, water, shoes, warm and cold weather resources. Office Equipment Rental Cell phones and laptops for the new team members and monthly cell phone costs for all the team. Office Supplies/Materials Uniforms and office supplies for new team members. Service Related Supplies Funding for medical supplies and harm reduction supplies for mobile unit. Software Licenses Penelope and Apricot software and licenses. Vehicle Rental Mobile van rental from Enterprise. Alliance Health Budget Form for Non-UCR Contracts Narrative 4 NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Mental Health, Developmental Disabilities and Substance Use Services JOSH STEIN • Governor DEVDUTTA SANGVAI • Secretary KELLY CROSBIE • Director NC DEPARTMENT OF HEALTH AND HUMAN SERVICES • DIVISION OF MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE USE SERVICES LOCATION: 695 Palmer Drive, Anderson Building, Raleigh, NC 27603 MAILING ADDRESS: 3001 Mail Service Center, Raleigh, NC 27699-3001 www.ncdhhs.gov • TEL: 984-236-5000 • FAX: 919-508-0951 AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER AAugust 22, 2025 MEMORANDUM Allocation #: 26-A-51 UEI #: WX6EEKYAMG77 TO: Rob Robinson, Chief Executive Officer Alliance FROM: Deidra Oates, Business Allocations Manager DMHDDSUS RE: Behavioral Health Investments Special Savings Funding Non-UCR for Orange County Mobile Crisis and Law Enforcement Co-Response Pilot SFY26 Alliance is allocated $$790,640 in Behavioral Health Investments Special Savings Funds on a oone- time basis to support the development and operation of the Orange County Mobile Crisis and Law Enforcement Co-Response Pilot. Eligible expenditures must be incurred during the period of July 1, 2025 through June 30, 2026. FORMAT FOR FUNDING: These state funds are allocated ooutside of UCR and approved expenditures shall be reported by the Tailored Plan through routine submission of monthly Financial Status Reports (FSRs) to the DMHDDSUS Project Manager and Business and Financial Operations. Funds will be paid on a reimbursement basis as these funds will not be paid via the Single Stream Funding payment schedule. Any exceptions to the required timely reporting of funds expended shall be approved in writing by the DMHDDSUS Business and Financial Operations Director. Each Tailored Plan should review their program report received from Business and Financial Operations for the latest expenditure update for funds paid by the Division. If Tailored Plans are underutilizing funds, the Division reserves the right to make a mid-year adjustment in allocations.           5 2 SSPECIAL CONDITIONS: 1. The award of these funds shall not be used by a county as a basis to supplant any portion of a county’s commitment of local funds to the area authority. 2. These funds shall only be used for community-based services and supports. 3. The funds provided shall not be utilized to supplement any reimbursement for services or staff activities provided through the NC Medicaid Program; 4. Funds shall be used in accordance with cost principles describing allowable and unallowable expenditures for nonprofit organizations in accordance with OMB Circular A-122; 5. Tailored Plans are prohibited from withholding or deducting any portion of allocated state funds for the support of any Tailored Plan activity or function, including, but not limited to, administration, overhead, or indirect expenses. All allocated funds are required to be fully contracted by the Tailored Plan for approved expenditure by eligible non-profit subrecipient organizations. 6. If Tailored Plans are underutilizing the funds allocated, the Division reserves the right to make adjustment in allocations. 7. Any payback of funds provided to the Tailored Plan pursuant to this allocation and determined to be owed by the Tailored Plan as a result of the funding review and settlement process conducted by DMHDDSUS for each fiscal year, must be paid within 60 days after the date of Tailored Plan’s receipt of the non-Medicaid funding audit report memorandum (financial settlement memorandum) from DMHDDSUS. If not timely paid, DMHDDSUS will take action to recover any such payback amount due from the Tailored Plan. The Tailored Plan will be provided prior written notice of the process to recoup any payback funds owed and not timely paid by the Tailored Plan and any appeal rights to contest the payback amount due, in the financial settlement memorandum from DMHDDSUS. 8. NC DHHS has an approved cost allocation plan which exempts the State from the indirect cost rate requirement for Federal awards. 9. NC DHHS does not allocate pass-through funds identified as Research and Development. SPECIAL REPORTING REQUIREMENTS: The following reporting requirements are required as referenced in G.S. 122C-144.1. Budget Format and Reports: In order to ensure the Division has complete and accurate information on services provided and expenditures, reporting of all services is required through NC Tracks and the Financial Reporting Tool, Financial Status Reporting Monthly Expenditure Detail worksheets. This will enable the system to assign eligible services to the correct disability-based accounts. Complete reporting of services is also essential for performance measures calculated from NC Tracks claims and encounter data. Monthly and Quarterly programmatic reports should also be submitted to the Program Manager.           6 3 FFUND ALLOCATION: NCFS: Agency Budget Fund Account Agency Mgmt. Unit (AMU) Agency Program Funding Source Project Amount 3000 231013 56900100 30TB183 300003B 2000 2000400000 $790,640 Please do not hesitate to contact JJessica Kornegay at jessica.kornegay@dhhs.nc.gov regarding any questions or concerns about this allocation. cc: Tailored Plan Finance Officer DMHDDSUS Business and Financial Operations Team DMHDDSUS Executive Leadership Team           7 Fund Budget Summary General Fund Grants Fund Original Budget Revenue $298,315,586 $283,500 Interfund Transfer Revenue $665,729 $0 Fund Balance Appropiation $7,056,130 $0 Total Original Budget $306,037,445 $283,500 Additional Revenue Received Through Budget Amendment #2-A (October 7th) Grant Funds $279,615 $953,558 Non Grant Funds $123,489 $23,611 Additional Interfund Transfer Revenue Additional Fund Balance Appropriation ‐$69,497 Total Amended Budget $306,371,052 $1,260,669 Dollar Change in 2024‐25 Approved Budget $333,607 $977,169 % Change in 2024‐25 Approved Budget 0.11% 344.68% Year-To-Date Budget Summary Fiscal Year 2025-26 8