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HomeMy WebLinkAboutORD-2025-032-Approval of Budget Amendment #2-A to fund the mobile Crisis team polit-care-wth grant funding 1 0RD-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) : INFORMATION CONTACT . FY 2025 -26 Alliance Health Budget Caitlin Fenhagen , 919 -245 -2303 Form Expansion Kirby Saunders , 919-245-6123 August 22 , 2025 Memorandum from Kim Woodward , 919 -245 -6133 NCDHHS Year-To - Date Budget Summary 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 51/o of the responses required transport to a hospital for a medical emergency , and only 71/o 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 . 2 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 FY 2025-26 Amendment Revised Grant Revenue $ 579 , 500 $790 , 640 $ 1 , 370 , 140 Total Project Funding $579 , 500 $7901640 $ 1 , 370 , 140 Appropriated for this project : Current FY 2025-26 FY 2025-26 FY 2025-26 Amendment Revised Expenditures $579 , 500 $ 790 , 640 $ 1 , 3700140 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 . 3 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 . 4 Alliance Health Budget Form for Non-UCR Contracts Narrative 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 invoicing travel . Funding for basic needs including snacks , clothes , water, shoes , warm and cold weather Client Assistance Activities resources . Cell phones and laptops for the new team members and monthly cell phone costs for all Office Equipment Rental the team . Office Supplies/Materials Uniforms and office supplies for new team members . j Service Related Supplies Funding for medical supplies and harm reduction supplies for mobile unit . t f t Software Licenses Penelope and Apricot software and licenses . Vehicle Rental Mobile van rental from Enterprise . i i l i Z (yI E E gE� 3 p€ i q� Docusign Envelope ID : 110C5B7D-DB75-493A-B8A8-0081AED27025 5 �� srareo NC DEPARTMENT OF h �y HEALTH AND JOSH STEIN • Governor HUMAN SERVICES DEVDUTTASANGVAI Secretary y% ,_ Division of Mental Health, Developmental KELLV CROSBIE Director 'uaQW4vat' Disabilities and Substance Use Services August 22 , 2025 MEMORANDUM Allocation #: 26-A 51 UEI #: WX6EEKYAMG77 TO : Rob Robinson , Chief Executive Officer Alliance DocuSigned by, 0 LG40LLa OA` I G0 FROM : Deidra Oates , Business Allocations Manager 6� 66E53CFAB2CD461 ... 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 one- 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 outside 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. 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 Docusign Envelope ID : 110C587D-DB75-493A-BSA&C081AED27025 6 SPECIAL 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 i and any appeal rights to contest the payback amount due , in the financial settlement memorandum from DMHDDSUS . S . 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 . i 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 . i i i I 1 2 Docusign Envelope ID : 110C587D-DB75-493A-B8A&C081AED27025 7 FUND ALLOCATION . NCFS . Agency Budget Account Agency Agency Funding Project Amount Fund Mgmt . Program Source Unit (AMU ) 3000 231013 56900100 30TB183 300003E 2000 2000400000 $ 790, 640 Please do not hesitate to contact Jessica Kornegay at 1essica . kornegay0dhhs . 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 3 8 Year-To -Date Budget Summary Fiscal Year 2025-26 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 $ 231611 Additional Interfund Transfer Revenue Additional Fund Balance Appropriation - $ 69, 497 Total Amended Budget $ 306 , 371 , 052 $ 1 , 260 , 669 I Dollar Change in 2024-25 Approved Budget $ 333 , 607 $ 9770169 Change in 2024- 25 Approved Budget 0 . 11 % 344 . 68% f i i i E { i