2013 2:00:00 PM

Monday, March 11, 2013 2:00 PM
Sparks Council Chambers, 745 4th Street, Sparks, NV

Consent Items: 5.6

Title: Consideration and possible approval of a revised Agreement among WestCare Nevada Inc., Local Governments within Washoe County and Northern Nevada Hospitals relating to the provision of funds for the Community Triage Center

Petitioner/Presenter: Westcare Nevada Inc./George Graham, Housing Specialist

Recommendation: Staff recommends approval of the revised funding agreement for operation of the Community Triage Center

Financial Impact: $86,121 from the City’s General Fund (this agreement and funding was previously approved by the City Council on October 22, 2012)

Total Costs: $86,121.00

Fund: General Fund Account: 603170
Program: Community Support-Contributions to Other Governments (059042)
Amount: $86,121.00 Budget Status: Over Budget (See Budget Correction Plan)

Budget Correction Plan:
No additional financial impact at this time, funding has been encombered.

Business Impact (Per NRS 237):
A Business Impact Statement is not required because this is not a rule.

Agenda Item Brief: This is a revised version of an agreement previously approved by the Sparks City Council on October 22, 2012. The sole modification is the removal, requested by Washoe County, of Section 5 on page 5, the effect of which is to eliminate the requirement for a committee to provide oversight of the CTC. The agreement provides funding for WestCare to operate the Community Triage Center (CTC) located on the campus for the homeless in downtown Reno (i.e., the Community Assistance Center). The CTC serves chronically inebriated and/or mentally ill individuals as well as adults who do not have access to health care or emergency medical services based on their homeless and/or indigent status. Per the terms of the agreement the City of Sparks would provide $86,121 during the current fiscal year. Other entities agreeing to provide funding are Washoe County, the City of Reno and five medical centers (i.e., hospitals). Total cash funding to be provided by the parties to the agreement is $951,121 which will leverage an additional $500,000 in State of Nevada funding.

Background: In 2005, the Nevada Legislature approved AB 175 that called for creation of a centrally located drop-off triage center for those mentally ill persons and chronic inebriates. The legislation stipulates that the State of Nevada will provide one third of the funding with two thirds to be provided by local governments and hospitals. In 2008, the Community Triage Center (CTC) opened on the campus of the Community Assistance Center in downtown Reno. WestCare’s operation of the CTC has been funded from a combination of State of Nevada mental health funding, Washoe County, the City of Reno and local hospitals, primarily St. Mary’s. In 2011-12, WestCare operated the CTC at a financial deficit. WestCare is not obligated to operate the CTC and has asked that a funding agreement be put into place to provide adequate funding as it cannot continue to operate the CTC at a loss.

Analysis: This is a revised version of an agreement previously approved by the Sparks City Council on October 22, 2012. The sole modification is the removal, at the request of Washoe County, of Section 5 on page 5, the effect of which is to eliminate the requirement for a committee to provide oversight of the CTC. The Community Triage Center was initiated to serve chronically inebriated and/or mentally ill individuals as well as adults who do not have access to health care or emergency medical services based on their homeless and/or indigent status. The CTC is operated by WestCare Nevada, Inc., a non-profit organization whose services include substance abuse and addiction treatment, homeless and runaway shelters, domestic violence treatment and prevention and mental health programs. The CTC program provides savings for local law enforcement, emergency responders, hospital emergency rooms, the Washoe County Detention Center, and generally serves as a safety-net in the community. The clients served report income at or below the poverty level and/or are chronically homeless, and are not eligible for Nevada Medicaid. The CTC is the only resource of its kind in the region, and with the exception of hospital ERs, whose services are limited to medical stabilization and discharge only, there are no other detoxification and crisis stabilization entities which are available 24-hours per day and accept the uninsured. Additionally, there is no discharge planning occurring for these individuals in the ERs, so the clients were returned to the streets. In most cases these clients end up back in the ER within days, or hours, of the previous discharge, costing the community significantly. CTC treatment can be offered by registered nurses, nurse practitioners, medical assistants, and substance abuse counselors, psychiatrists, case managers, thereby limiting the number of repeat ER visits. As of May 1, 2012 the CTC began to accept all “Civil Protective Custody” detainees from local law enforcement agencies, including the Sparks Police Department. This has decreased law enforcement’s time with this population as they can now bring them to the CTC. In addition, WestCare has been performing medical screenings, and when clinically indicated, a medical clearance so that law enforcement isno longer required to take a detainee to an emergency room for this prior to being taken to the jail. Only those refusing to stay at the CTC, or those who are too violent, are being sent to the Washoe County Detention Center. For FY 2012-13, and as delineated in section 2 of the Agreement, a group of five medical centers will provide a total of $500,000 in funding during FY 2012/13. Washoe County is to provide $190,000 in cash plus $263,258 of in-kind assistance while the City of Reno is to provide $175,000 in cash and $106,000 of in-kind assistance. The City of Sparks is to provide $86,121. Total cash funding to be provided by the parties to the agreement is $951,121 which will leverage an additional $500,000 in State of Nevada funding.

Alternatives: The City Council’s options include not approving the revised funding agreement for the CTC or modifying its terms, subject to concurrence by all of the other parties to the agreement.

Recommended Motion: I move to approve the funding agreement between the City of Sparks, the City of Reno, Washoe County and five northern Nevada hospitals for WestCare Nevada’s operation of the Community Triage Center.

Attached Files:

CTC Agreement with provision removed 2-13.pdf

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