Healthy and Safe Communities

Provide quality and equitable housing, health, and human services for all.

Goal 5, Objective 2

Better integrate services and handoffs within the Safety Net departments.
On Track

Updated: January 2023

Summary of Objective Implementation Status

This objective is comprised of 6 initiatives that together create the County’s ACCESS-Sonoma Cohort System:

  1. Interdepartmental Interdisciplinary Team (IMDT)
  2. Homeless Encampment Access and Resource Team/  COVID-19 Emergency Response Grant  (HEART/CERG)
  3. Mental Health Diversion Expansion
  4. Whole Person Care/California Advancing and Innovating Medi-Cal  (WPC/CalAIM)
  5. ACCESS-IMDT Data Solutions
  6. Operationalizing the recommendations provided in the KPMG report Assessment of Housing and Homelessness Services

Key Milestone Update

  • On January 2023, the “Ending Homelessness” unit of the Community Development Commission (CDC) will transfer to Department of Health Services (DHS) and be established as the “Homelessness Services” Division.  This was a recommendation of the KPMG report.
  • The WPC pilot program funded by the state ended 12/31/2021.  It will be replaced by CalAIM.

Coordination and Partnership Update

The very concept of ACCESS-Sonoma is based on the use of the IMDT that require collaboration from various County agencies.  County staff from DHS, (Human Services Department (HSD), Community Development Commission (CDC), Child Support Services (CSS), Information Systems Department (ISD), Courts, County Counsel, District Attorney (DA), Public Defender, Probation, Sheriff, and County Administrator’s Office (CAO) work across agencies to provide “wraparound” services to clients through coordination by Artificial Intelligence from government contractor IBM’s Watson-Care Management (WCM) platform.

In addition, the aforementioned County Agencies & Departments have partnered with a host of community-based organizations (CBO’s) to deliver these services for greater efficiency and efficacy.   These CBOs include, but are not limited to the following:

  • West County Community Centers (WCCS)
  • Humanidad
  • Committee On The Shelterless (COTS)

Community, Equity, and Climate Update

2019 census data shows that a percentage of individuals experiencing homelessness and identifying as White in the unsheltered population is 65% versus the overall White portion of the county at 86.8%. By contrast, the percentage of individuals experiencing homelessness and identifying as Native American (including Alaska Native) is 6% versus this group’s 1% portion of the general population.

Furthermore, the percentage of individuals experiencing homelessness and identifying as Black (or African American) is 9% versus this group’s 2% portion of the general population.

The ACCESS-Sonoma cohort initiatives address racial equity simply by deploying government services and resources that otherwise would not reach the underserved, unsheltered populations.

Funding Narrative

The cost of administering these ACCESS-Sonoma cohorts is about $5.2 million per annum.

    • Expenditures by the IMDT and HEART cohorts are covered by a combination of funds:
      1. Measure-O
      2. CERG (COVID-19 Emergency Response Grant) from County Medical Services Program (CMSP)
      3. FEMA
      4. County sources (e.g.,  General Fund)
    • The Department of State Hospitals covers the $410,760 cost of the MH Diversion program.

The SAMHSA grant covers about $1.6 million.

FY 2022-2023:

PhasesBrief DescriptionAmount
1.Interdepartmental Multi-Disciplinary Team (IMDT) $2,284,886
2Homeless Encampment Access & Resource Team/COVID-19 Emergecy Response Grant (HEART/CERG) $ –
3Mental Health Diversion Cohort Expansion $410,760
4Whole Person Care (WPC) transition to CalAIM (California Advancing and Innovating Medi-Cal) $ –
5IMDT Data Solutions $1,600,000
KPMG-based Initiatives
a) Data-mapping of city systems
b) Bridge between city & WCM-Hub
c) IBM Cognos Business Intelligence
d) 0.5 FTE ISD Project Manager
e) 0.5 FTE ISD Program Manager
$ –