Health, Housing & Human Services Committee - Regular Meeting

No. And there are questions, comments, suggestions that you have. And that's the end of it. It'll be fast. I told you.

That was fast. Thank you, Roxanne. And thank you for just staying so on top of these opportunities and bringing them forward to us. I think it's just really,

really

important that we're we're we're taking advantage of these these funding opportunities every every chance we get. Supervisor Alejo, it's it sounds like your district, and I'll let you jump in with some comments and

see it.

Partially mine, partially Glen Church's district on Davis Road. But I wanted to say thank you, Roxanne. Obviously, we've talked already about the county has talked to the city of Salinas on this, and so they're ready to proceed. We we're just trying to tag team on this effort. Right? If you could just elaborate on on where where the city is in terms of applying and when when is the deadline, to submit the ERF grant proposals?

The state is pretty behind on releasing the incumbent resolution request for funding applications, I think or request for applications, NOFA. We are expected that they would open it before the end of this year, and we are expected that it would be due by maybe the latest February. The city is in a interesting position right now where their current city council wants them to focus more on economic development. So because the county has such extensive history at this point now with pursuing and being awarded incumbent resolution funding, and we certainly have an interest in assisting wherever we can, There is a MOU that we've developed with the city. It's planning on going to the board on November 4 for approval, where it shows that we will be responsible for pursuing the grant similar to what we have with Soledad, but the city will be responsible for all of the capital improvements.

And then we are working with the coalition of home services providers for us to identify a service provider for the project. That's the first proposal. The second pro sorry. Supervisor?

No. I was just so I was gonna just just clarify that. So so we will be lead on the application then?

Correct. Okay.

But we will not own any assets in

this Right.

Situation.

Yeah.

The second proposal is referencing the HomeKey's. Collectively, there's about a 150 units that's in the city of Salinas that will be coming online over different periods of time. It's all permanent supportive housing, so it's for people who are chronically homeless and have an identified disability. There certainly is a need in the city of Salinas considering they have half of the whole entire unsheltered population for the entire county. And, again, just trying to figure out where we could leverage our different assets and resources and considering the fact, again, that we have been successful, we think that we should pursue it. And the second one is strictly rental assistance and outreach, It's all services that we're offering.

Great. Well, Roxanne, like, supervisor Askew said, we're very grateful that, you're willing to, help us, on these applications and to see well, we could partner with with the City of Salinas and our nonprofit, homeless service providers. That's, I think, a win win for the community, to bring in as much resources as we can while they're still available, to put to good to put to good use. So thank you for that, and I'm fully on board on both applications.

Thank you, sir.

And so, what would the next steps be, Roxanne? What else do you need from this committee? Do we need to go to the full board? Does this need to go to the full board for direction?

Correct. We will be going to the full board. We have a scheduled item on November 4 to to talk to talk about the two different proposals and to get approval for for the CAO to sign the MOU between the city and the county, and then we just submit the application and wait. Unfortunately, this year, the state has significantly reduced the amount of money that's available in the ERF. There's only a $100,000,000 that's available. It's kind of odd to compete against ourselves, but we have had experience in the past where we submitted two applications and was awarded both.

Okay. Excellent.

What are the

amount Yeah. Go ahead.

Yeah. I was just asking the amount for each grant. What's the the goal?

So far, just penciling it in, we still have to engage with the potential service provider, but I'm estimating each one would be about $7,000,000. So 14 in total.

Thank you.

Of course.

And I guess just my only last question would be how quickly can we get this in front of the full board for action? And with the additional sort of thought would be, like, sometimes I I hate that we have to, like, have the bureaucratic process of having to have things go to committee first before they can go to the full board when we know it's something that the board has prioritized as something that they want us to be moving forward with. And so I generally would say, like, can we can for things like this, or we know there's gonna be support, or we anticipate, of course, there would be support. Are we able to move in parallel, you know, to have discussion on

the

committee aside, but also be be getting it agendized for the board to be well, while while we're also moving it through through the committee process. But how quickly can we bring it to the board?

It's actually scheduled for November 4.

Okay. Fantastic. Yeah. Love it.

Thank you.

That it was gonna be tight considering the fact that the board's gonna be in recess fairly quickly. So we we submitted both in parallel for the committee and the board.

One step ahead of us. Thank you, Rachman, for all the work you do. Okay. Is there any public comment on this item? We'll open it up for anyone in the room. We have no public comment. That's all. We've got Wes. Alright, Wes.

No idea. Of course.

Is there anyone online for public comment? You can raise your hand, and we'll get you, in the queue, but we'll hear from Wes first.

Alright. West Wise, Lewis Lawyer County Home Machining, co president. As far as what's gonna happen, I I know quite a few people along that stretch of road along Davis. And, I mean, those folks are highly independent, you know, highly functional. You know, if if they're all gonna get supportive housing, you know, and you kinda kinda keep more toward, making sure everybody's place and and everybody's belongings are are taken with them.

Nothing is destroyed. You know what mean? Or unless, of course, you can control them out of whatever hoarding aspects they have. You know? But but more or less, you're just keeping the the the root ball intact when when you remove these these trees or people. And they're pillars of our community, honestly, because they're they're coherent. You know? I mean, they they they earn their their money. They don't do drugs or whatever. You know what I mean?

So there there's beautiful people out there that they just can't afford rent, and that that's just where they're at. So, you know, we we need to make sure that that everyone is being provided for and taken care of, because you're gonna find 95% of people want to participate. They they they need to have their independence as well, but they're they're certainly always willing to cooperate, especially for something better. So I'll make sure that's what you're doing and not just robbing them.

That's okay.

And then tell them to leave, move on, you're a criminal forever because that that's that's what people are dealing with up into debt. And they're they're they're they're not having a good life, and and it shouldn't be the jurisdictions that that are causing state created danger from that.

Thank you, Wes. Thank you for the comments. Alright. So I think we don't need action on this, but we'll look forward to hearing it on on the November 4 with support from committee. Thanks. Moving on to item number two is to receive our overview from Natividad.

I was gonna ask you, are are we're not we're not giving a recommendation of support?

Oh, sure. We can

Yeah.

I think, yep, we can give a recommendation of support as it moves on to the November 4 full board. But Indeed. Yes. Sure. Support. Thank you. Okay. Item number two is receiving an overview from Intipidade and health department staff on Intipidade Medical Center's medical health unit and the sorry, and the health department's public guardian's office. And we have a whole team from the health department and Intipidade.

It's okay.

Good afternoon, the members of the public, and good afternoon, supervisor Askew and supervisor Alejo.

I know.

I'm happy to be here with my colleagues from the health department and public guardian's office and with you all, of course. Today, the health department, the public guardian's office, and the and the and its mental health unit are gonna present, on the, the the workflow and the relationship between the mental health unit and the public guardian's office as it relates to our patients, for this committee. I would like to, first introduce, Annalisa Lial, the nursing director of our mental health unit, who is going to take points and, present on, Natividad's mental health.

Would this be a place I say that we have to get this slide? Yeah.

So real quick. They're looking at

our you're seeing our backs. Right?

We we are seeing your backs.

Should to we face the camera?

You could just move your chairs the other direction, but we're also gonna just end up seeing the presentation on the Zoom.

Okay. So we

can just see voices and see the presentation is what we actually see. Okay. So it works.

Okay. Good afternoon, everyone. I'm Annalisa. I'm the nursing director at Natividad Hospital. I've been part of Natividad for twenty years, and I've been part of the mental health unit for the last twelve years.

So for those of you who may or may not know, Natividad's mental health unit, we are a licensed, 22 bed facility. We usually consider our us at full capacity when we're at 18 patients. We do have a total of 19 physical beds in the in the unit, so we use one of the beds as a swing bed, pending if it's a male or female. We are a LPS facility, and we are regulated, by title 22. The reason we're licensed for 22 beds is because we do have our patient intensive care area that it has three beds in that area, and each bed in the facility is licensed.

We are locked, and our nursing ratio is a one to six. So each nurse has six patients. We also do have a charge nurse that accounts. So at full capacity, we have four nurses on the unit. We have two nursing assistants, and pretty much our population are patients who have been brought in on involuntary holds.

And those can consist of a seventy two hour hold, a fourteen day hold, a thirty day hold, or an LPS hold. So most of our clients are admitted on a some type of legal hold. So kind of the flow of the patients. Patients arrive in the emergency department. They're either brought in by ambulance, police, family, or staff, and, or they can bring themselves.

They arrive into our emergency department. They are assessed by our, ER physicians, and then, our psych team then comes down and evaluates the patient. Our psychiatrist also assesses the patient. And then the determination is made whether the patient will be admitted or transferred or possibly discharged with aftercare support. So just to give you an idea of roughly the kind the amount of evaluations that we did, these these were numbers, that I took from this year alone from January to around, the September.

For evaluations, we had fifth, 1,595 evaluations that were all adults age 18 and over. We had 353 that were minors for a grand total of 1,948. Out of those evaluations, we admitted four hundred and sixty and zero minors as if I didn't make it clear earlier, we do not accept anybody under the age of 18. We are only adults in our unit. So all of the minors have to be transferred.

So, the next line is the transfers. As you could see, we transferred a 182 adults, and that's usually either based on our unit being at full capacity or if they belong to a different county, we try to get them back to their home county. Monterey, we we tend to attract a lot of individuals passing through, and so we try to get them back to their home counties. And we have transferred 22, minors as of this year. So go on to the next slide.

This this was a little bit of a change. I just wanted to add this. This is a list of all of the facilities that our transfer center uses, and depending on the age of the individual is where they would be transferred. The transfer center definitely attempts to transfer them to the low the most closest facility, to our county, and then they work their way out depending, what the individual's needs may be. We have a few facilities that do take them as young as five and four.

And, unfortunately, I do have to say we have had to transfer a few that have been at this age range. Okay. So on the next slide, I did put in a bit of information of the facilities that we do frequently use and give you some information on their bed capacity just to give you an idea of where these individuals go and the capacity or capabilities that they do have. On the next slide, I did a quick little breakdown of the different types of holds and the criteria to meet these holds. So we recently, in the past probably year, year and a half that we've been, implementing our fifty two seventy, which is our additional thirty day hold, which was a hold that we didn't utilize before, and this was to help some of these individuals and hopefully reduce the number of conservatorships, for those individuals who just need a little bit more time.

The average length of stay in our department right now is anywhere between, seven to ten days. On a fifty one fifty, fifty two fifty, they could stay up to a total of seventeen is our regular, length of like, in the regular length of stay that you could stay on these types of holds. But our average is about seven to to ten. The next slide, we have, just kind of the flow of how individuals, get referred to conservatorship. The physician recommends conservatorship.

The information is then passed to our public guardian's office. They review the case and make a determination if they're going to accept the individual or deny the conservatorship. And if it's denied, then we work on a discharge plan, possibly refer them to a care court. And then we, if we if the physician feels that the individual still needs more time, then we may end up discharging them against medical advice because we cannot hold them there past their legal hold, allows us to keep them. So if they do concur, we inform the patient, get sent to county legal, goes to for judicial review, and then it gets, the individual get placed on a temporary conservatorship.

Patient is served that they will be on the conservatorship, and then they can remain on a LPS conservatorship for one year. And during that time frame, they can also appeal for a jury trial if they disagree. But if not, they will be on that conservatorship for one year. Once they are conserved, they will be presented to behavioral health to assist for placement, for a long term care facility, which could include, you know, all kinds of different levels. On the next slide, we have our LPS referrals that we have submitted, which have been accepted, which have been denied, and the total amount of the referrals that we have sent in.

So the long term care facilities on the next slide, these are the different kinds of places individuals can go. Acute psychiatric hospitals, community, rehabilitation treatment centers, MHRCs, psychiatric health facilities, and SNFs. So just depending on what level of placement they need. They can also go to, like, a boarding care. Some have stepped down to Manzanita, which is a step down stabilization area.

So depending on what the individual needs are is how we get them to to the next placement. Something that we recently added this year, has been our enhanced case management. We started enhanced case management in, May 2025. And, initially, when we started this was our population focus was the justice involved youth transitioning to the community. And we recently, in July, started also with, our adults with, serious mental illness and substance use disorders.

And we've been hoping you know, with them discharging out of the hospital, we've been signing them up with our ECM program so that we can follow them and assist in their transition once they leave the hospital. At as of right now, we currently have about 85, enrolled, and we've been out following, the individuals during their transition, and it seems, to be doing really well. It's it's actually, I was joking with doctor Harris and talked about our census has been down in our unit, and maybe it's just because we're doing a great job with our ECM program. And so hoping that we can, assist our patients in getting the care that they need and helping them with that transition. And that concludes our presentation, and I'll go ahead and turn it over, or if anybody has any questions for me.

Thank you. I think, maybe let's do both presentations together, and then we can come back to the questions.

Sounds good.

Alright. Go ahead. Alright. Good afternoon, everyone. Supervisor Alejo, supervisor Askew. My name is Sarah Solano, and I am the chief deputy public guardian here in Monterey County. So there are several types of conservatorships in California, including a general conservatorship. These are typically established for adults who aren't able to care for themselves or manage their finances. There's a limited conservatorship designed for adults with developmental disabilities. And lastly, there's the Laderman Petra Short conservatorship, commonly referred to as the LPS conservatorship.

The Laderman Petra Short is a landmark California law that formed the state's mental health system designed to end the inappropriate, indefinite, and involuntary commitments of individuals with mental health disorders. Through this act, strict legal standards and procedures for involuntary psychiatric holds were established, including the fifty one fifty hold or the seventy two hour hold and civil rights due process protections. Senate bill 43 is a relatively new statute signed by the governor, first 2024, with the option for counties to delay implementation until 01/01/2026 is and that is what Monterey County decided to do. We've decided to delay implementation, we go live in January. SB 43 significantly updates California's definition of grave disability.

The old criteria under which people may be civilly detained according to the LPS act, pardon me, included danger to self, danger to others, or grave disability. However, SB 40 three's new definitions expand the concept of grave disability to also include people with a mental health disorder, a severe substance use disorder, or a co occurring mental health disorder and a severe substance use disorder who are unable to provide for their basic needs such as food, clothing, shelter, and now access to necessary medical care or personal safety. We currently have a total of 17 staff members. Out of the seventeen, ten of them are full time deputies. I'm gonna go to our deputy assigned cases on the next slide.

But before I go there, we do receive referrals from different sources. Our main source of referrals, they come from the Tivet Ave. We get them from CHOMP, Garden Pavilion, the criminal courts, and out of county hospitals. So right now, we currently have six sorry. That's okay. One moment.

How did I do that?

I

don't know how to put it back. Sorry. That was me.

It's still showing

because it's like

I think it is. Difficulties. We'll figure it

out. Okay.

I did the same thing.

Alright. Sorry. You were good. It was me. We

have 648 active cases. And out of the 648 active cases, 546 are assigned cases. So those miscellaneous 102 cases are unassigned for various reasons. However, out of those 648 cases, a hundred and fifty eight are assigned LPS cases. And that's the caseload that I'm gonna focus on today.

I know Annalisa, also went through this process, but this process also includes kind of what the public guardian's, office is looking at when we receive a referral. So obviously, the patient is admitted for inpatient behavioral health treatment. The physician then will assess for grave disability. So grave disability means the individual has the inability to provide. They only need to meet criteria for one, unable to provide for food, clothing, and shelter.

If the patient is not found to be gravely disabled, then they are released or they could stabilize. That could be for various reasons. If they don't stabilize within either a fifty one fifty, fifty two fifty, or fifty two seventy hold, then, the hospital may refer consideration of referral for conservatorship. So what happens is that the conservatorship office investigates. So we're looking at a lot of different criteria.

The investigation, these are in-depth investigations. We're talking to the individual. We're talking to the medical staff. We're talking to families. We are essentially looking, do they meet the legal definition?

Do they have the ability or do they not have the ability to provide for their own food, clothing, and shelter? Also, we're looking for least restrictive alternatives. Obviously, we don't wanna place somebody on a conservatorship and swipe away all their civil rights if we don't have to have to. So some of the legal restricted alternatives may be, either care court or third party assistance, someone like a family member, a friend who is willing to help the individual. If we, if we don't agree, then it's denied and the case is closed.

If we do agree, with the physician, then we our county counsel will file a petition with sorry. That should say superior court, not supervisor court. I apologize. And then if the court finds that the individual is gravely disabled, then the court may enter an order for conservatorship for a temporary conservatorship or one year conservatorship. Each conservatorship that's under a one year is reevaluated each and every year.

So these are in per in perpetuity. If the individual gets better, if they stabilize, they reach baseline, obviously, our end goal is to reintegrate these individuals back into the community, back with their families. So the summary of dates that I went, I started from January 2025 up until 2000 or, pardon me, 10/14/2025. These are the number of referrals that we've received per entity. So Natividad, obviously, most commonly is where we get our referrals.

We received 23. CHOMP, one. The criminal court, 13. So the criminal court referrals are for individuals incompetent to stand trial. So they they have some sort of criminal component. They try to go through restoration. Restoration determined that they're incompetent, and so sometimes we will get a referral for consideration of conservatorship. And in other, meaning probably out of county referrals, we have six. Out of those, we've denied a total

of

16. We've accepted and petitioned 18, and currently two are pending determination. So there are different, LPS facilities according to their their needs. So we have 24 at the boarding care level. This are pardon me. 54 at the boarding care level. This is our lowest level of care. Two are deceased. We don't need to worry about those folks. Three are in the hospital.

Thirty seven are at an IMD level institution for mental diseases, and this is our second highest level, below a state hospital. One at a psychiatric hospital, 14 at a skilled nursing facility. Many of those folks at the skilled nursing facility are our aging LPS clients who have both LPS component and physical needs that need to be met, And then 11 at the state hospital. State hospital is our highest level of care.

So just to wrap up, and you'll hear me as a broken record because we've been doing our rounds about just a future opportunity of building a local mental health rehabilitation center campus off of the constitution. So our clients that are placed out of county, their family, unfortunately, is not able to visit them. And we know that being connected to their loved ones is critical in their path towards treatment and being able to come back into our community. We heard a little bit from our partners at Natividad, that sometimes the demand for inpatient services exceeds the number of beds they're able to fully staff and occupy. And so this could mean that there's longer wait rooms in our local emergency departments, that there's, you know, people that are placed in our local mental health unit or other psychiatric facilities, may have to wait longer because of the fact that our referral to a higher level of care, whether that be an IMD bed or a state hospital bed, there's a backlog.

And so we're putting on a waiting list. And so some of our patients end up staying in a local psychiatric facility for much longer than needed, which really impacts the hospital's ability to occupy that bed with somebody who meets medical necessity for that level of care and is also getting a much lower rate for those days that are considered administrative days. And so in terms of opportunities, in a few years, we'll have, hopefully, our mental health rehabilitation centers constructed, pending board approval later this month, which will keep our clients in our community better connected to their loved ones, better connected to their care team, and really provide a quick transfer from our local hospital beds into those facilities. And so with that, we'll take any questions from the health department public guardian office and from, Natipnad.

Great. Thank you so much for this presentation. I know it was something I'd asked for, at a previous meeting, and it's one of those services that the county provides that takes a lot of skill and expertise and care and compassion. I know it's a really challenging space to work in and not something that we oftentimes, I think, talk about or really go into detail in terms of explaining the nuances of how this type of programming or this type of care is provided. And thank you for sort of opening the curtain to provide a little bit more of context and explanation.

I'm gonna pass it to Luis for starting comments and questions, and then I have sort of a list of some additional comments and questions, and then we can go open up to public comment.

Yeah. I just wanted to add that I think I think it was very informative. This area of of care for folks who who are who are I I would say have high needs in terms of their substance or their mental health, necessities. So thank you for the presentation, first of all, because I I agree. We don't, have these conversations about this service that the county provides for for families and individuals who who who need their loved ones in this type of care.

And, you covered all the questions I had out in terms of how many conservatorships, more or per year, the distinction between adults and and minors. But, the two questions I still have would be just on on care court. Right? So you have the conservatorship process. Now we have a new fairly new CareCourt process. How do those two interact with each other? And I know the last presentation we got on CareCourt, had very few cases. But how how did these two different procedures interact with each other, perhaps aimed at serving the the similar individuals or needs of similar needs of individuals?

Do you want to start? Sure. So during the whole process at the hospital, the CareCore can initiate several different ways. But through the hospital stay, the doctor can recommend CareCore, instead of conservatorship. Anyone in the community can recommend CareCore.

Can be a family member. It can be a social worker. It's open to anyone. So versus an LPS, only the public guardian's office can file for a petition for guardianship or conservatorship, whereas the care court, anyone can can ask and file documentation for the care court proceeding. Here, particularly how the, public guardian's office is utilizing care right now is for step down.

So let's say we have a a, individual who's been conserved for several years. And to help them successful successfully reintegrate into the community, to give them a soft landing, then we do offer CareCourt. One of the components to Care Court is they have to have a schizophrenia based illness only. Whereas an LPS, it can be SOD. It can be schizophrenia. But for care, it it can't be SUD. Elsa, am I forgetting anything?

I I think just, you know, for somebody who is still deemed gravely disabled because of their condition would not be eligible for care court because those individuals have to be in an institution that's best able to meet their needs. And so as Sarah said, you know, for those that have been on conservatorship but are yet maybe not you know, they're they're able to care for themselves but might still need additional support, then that's where the warm handoff with the care court would be. And I see Melanie is on. She can help fill in any of the blanks. And so it would be just an additional layer support for somebody who's probably more out in the in the community based setting but still needs additional support to fully integrate in into the community. I don't know

if Nativida does any direct referrals. So I I think the one, thing to to kinda keep in mind is CareCourt. The individual has to be able, to participate and willing. Mhmm. It makes it very difficult, which is probably why the numbers are so down.

I mean, it's also a very complex process. I mean, I I don't know what the current number is, but when it first came out, it was, like, 24 different hearings in court that needed to occur where the individual has to show up. And I think it just CareCourt is is great, but a lot of our clients that we do refer for conservatorship just would not be willing to participate or able to participate in in CARE Court. And I think that's where it gets a little bit complicated.

Mhmm. So so what do our case court what what do those numbers look like in our the caseload in our county so far since it

Our care would probably best be answered by Melanie since behavioral health oversees those. And I haven't

seen her turn off her mic, so I don't know if she's actually there.

I Yeah.

Oh, there she is.

Hey. I'm

here. And I was gonna say a big distinction between LPS and CareCourt is CareCourt is a more their folks have to participate voluntarily even though it does have that civil court oversight. So that's a big distinction is the involuntary nature of LPS conservatorship versus the voluntary nature of care. We have seen other counties across the state as well as had conversations here between behavioral health and public guardian around using care court as that step down from LPS so that folks have a softer landing back in the community. So if they get on a temporary conservatorship or a full conservatorship and then they they stabilize in placement, and then they're looking to come back to the community to help with that integration, looking at, transitioning them into care with some of that continued court oversight.

We actually have a situation here in our county where the same judge is overseeing both LPS and care, so there is also continuity there. And then we can step them down from that involuntary to a more voluntary engagement, under care, and then hopefully, eventually, in keeping with that idea of least restrictive to voluntary outpatient services back in our community clinics. Our numbers, know, supervisor, we're preparing to come to the board after that full year of care and present some data. I'm sorry. I don't have current data, but I can pull it from our manager and get those numbers to you.

I think, mostly, we have seen a few petitions filed by family members, and we have seen some that have been referred for conservatorship and also care petition where then we have really partnered with Sarah and the public guardian's office to really determine, looking at everything we know about individuals, what's the appropriate level of care. Is it LPS or is it care? And so we've really been trying to coordinate closely around that as well, but I'm happy to provide you get some current numbers and provide them to you.

Well and if if you're working on it for another day, Melanie, that's fine. As long as it's you're you're gonna work on that one year report, so, I'll look forward to it then.

Yeah. Yeah. We we do plan on coming we were planning on coming in December, but we'll come in January to this committee to provide a a one year look into the implementation of care, and we'll have all those, numbers for you then. If you need them sooner, just just ping me, and we'll get them to you.

Right. And then last question also just on, how the the mental health unit and Actividad would interact with a future rehabilitation center on our on our, property there off constitution, would would would the mental health unit still remain in the hospital? And then then as they exit Yes. For the rehabilitation center. Right? Okay. So so

Yes. So so look at the the hospital as an acute care facility. So we take them in as they come in, needing a high like, we would be considered a higher level of care. Mhmm. On my PowerPoint, we put, like, examples of long term care.

So we we then transfer them to these facilities once they are accepted. I don't have the details right now as to what, what exactly the the clients that, Elsa is planning to put there because we as you could see in her PowerPoint, it had the breakdown of people who are at a skilled nursing facility, which is the aging population Mhmm. IMD level, MHRC, like, you know, what what is gonna be her acceptance or criteria depending on, how she decides to to staff it. You know, I individuals that we have sometimes have legal, matters that prohibit them from going to certain IMDs. If if they're a two ninety, sexual registrant, we do have a facility that is able to take them, and then we have other facilities that are not able to take them.

One of the facilities is too close to a day care, so, you know, those individuals can't go there. So it just really depends on once this goes live, what the licensing and the, admission criteria will be to to determine, which individuals will go to to this placement. But we would, hopefully, if it does happen, send to our facility since it's here and it's local to be able to keep to our patients local.

Thank you. Thank you for that. Appreciate it.

Yeah. Great. Thank thank you. Great questions. And I think it's sort of it's all of these pieces that all fit together, and it is so complicated. And God bless our team for understanding how how one piece fits into the next piece. And so I think some some of my questions are really around that. And in terms of understanding so cur and I'll go back to this. So currently, do we we don't I didn't see under the summary of placement types. We don't currently have any of our LPS placements at an MHRC?

Do we have some of our other of those 648 cases, do we have some of our other placements at an MHRC?

So so we do. I we do have some at, that are placed at an MHRC. So one of the common I I didn't bring that list with me, but we do have an MHRC that's located in, Delhi where they actually take some of our forensic patients. They do have a disruptive behavioral unit for our high intensity cases, and they do have their regular IMD with the step down. I think Oh, okay.

Yeah. No. I was I was

just looking at the slide that had the the summary placement test. I didn't see an MHRCA on it. That was just the LPS patients that you were looking at where there the those placements are currently.

Yeah. So I think you just classified them as IMD, but they're because they're locked, but we do have some of those facilities that are classified as an MHRC.

Yes. Oh, so the IMD placements are it's IMD, but some of those are classified as MHRC.

Yeah. And some of them are skilled nursing facilities because they are locked. So I see. Yeah. So they they do have different classifications, but yes.

I see. Okay. And then on going back to the mental health unit, and so we have the 22 beds. And I guess so so so the folks that come through that facility, are there diagnoses that we're seeing that all like, what what are the diagnosis that they does everyone that come through there end up with a diagnosis? Are there standard diagnoses? Is someone required to have a diagnosis?

Yes. So our physicians, we have psychiatrists who are in the emergency department twenty fourseven. So we have an in person psychiatrist who is down there, and then we do telepsych overnight. But we do have a psychiatrist down in the emergency department, seven days a week, you know, three hundred sixty five days a year. And, they do assess the individual.

They give them a working diagnosis, and by the end, they give them a a more of an official diagnosis. Most of the diagnosis that we see, as you know, I we have about ninety eight percent that are involuntary. So what we're seeing is the serious mental illness patients, the SMIs, schizophrenia, bipolar. We do get a few that are have depression, but primarily, you see the schizoaffectives, serious mental illnesses with our clients.

And and I guess and maybe this is part of my ignorance, but to so we see it and I don't know know what like, when you say serious mental illness or, like, bipolar or schizophrenia, is that something that it's like when are you able to make a diagnosis of that in a in a setting of an emergency room or in a setting of a of a short term engagement with an individual?

So usually, out of the emergency department, they observe the individual, you know, to be in there, to be medically cleared. There it is does take a process. So it's they're they could be there from ten to twelve hours, if they are admitted. And so at times, the doctors will use more generic, like undetermined psychosis. A lot of the ones that do get discharged back home, either already have a mental illness diagnosis that they're coming in because they miss their long acting injectables or they're under the influence of drugs.

And so they tend to clear up and, can be discharged home. Individuals who then get admitted because they, aren't able to agree to treatment or medications or need to more time. And so then the doctors work with them to get, treatment, and then they make the final determination on their diagnosis based on the time that they've been there and then their history.

Okay. Okay. And so then and so the folks that get admitted into the mental health unit, it's a range of diagnoses that are mental health or, like, assumed diagnosis is based on the limited information that we have? Yes. Okay.

And then so while they're in the and then can you go back to the slide that showed, or I have it, I think, up on mine, about the number of cases that are referred to so that the physician in the mental health unit makes referrals for conservatorship. And I think that someone had said that there's a a goal to reduce the number of conservatorships. I think I'd I'd written that down. And so there's a we've been re in we've been reducing those numbers over time. And is the is it the same number of referrals?

So it it looked like there were more referrals being made over time, but less referrals being accepted over time. I couldn't didn't get a chance to see those numbers as quickly.

Oh, that's on are are you talking about the one that we presented from Natividad on slide 10?

The there was a different set of slides that were presented versus what I had in my notes here. But yeah. So, like, in 2029, there were a total of nine referrals. Or 2022, there were nine referrals. In 2025, there were 25 referrals. So I guess it's, like, five were accepted in 2022, six were accepted in 2023, seven in 2024, and nine in 2025. But it looks like there's more and more referrals being made over time. But yet there was a goal to reduce the number of conservat total conservatorships that are being

So so I don't I I don't think the goal is to reduce them. I think the goal here, because when you put somebody on conservatorship, you take all of their rights away. And so if there are alternatives to conservatorship, then that is what we're going to explore from the public guardian office. Now, anybody that meets the great disability because of their severe mental illness, they're not able to clothe themselves, feed themselves, or house themselves, and then that's been determined by two psychiatrists and then confirmed by the public guardian office. Those are the individuals that we move forward to the court through the court system to be considered for conservatorship so we can get them the right level of care that they need.

But we're not going to just conserve everybody just because. Because again, if there are other alternatives to that, previously, if if people are becoming stabilized and they're willing to accept treatment and willing to participate through the care court process, that could be a potential alternative to conservatorship. Or it could be that now that we're instituting the additional thirty day hold with the $52.70, then the provider care team has had more time with the client to be able to get them on the right medication regimen and to get them stabilized. And so now they're no longer deemed greatly disabled because of their SMI, and so then they could be discharged back into the community, back into a boarding care, or, other lower level of, of care that they need.

Okay. No. That that does make sense that we have more options. So I guess I'm just I'm curious, like, if the because the the trend from to have the number of unless I'm reading this chart wrong, the number of referrals that are being made to be doubled in such a short period of time.

So so, supervisor, ask you

Yeah.

'22 and '23 was still COVID times, and, our census was down during COVID, and, placement options were less. If if I if I would have brought the pre COVID numbers, we actually had, I I want to say, between 25 to 40 referrals before COVID. So that might help explain 2223.

It does. It does very much. Thank you. That's very helpful. Thank you.

Okay. So then that's so this is sort of returning back to, like, where the standard referrals were coming in at and back to where the standard acceptance and denials were at. And so the and so to to to be more more clear, the folks that are coming into the MHU who are being referred by the doctors at the MHU for conservatorship, these are folks that the physicians are saying, this is someone who maybe I don't have somewhere to to like, why would a doctor be referring someone into conservatorship and then that person being like them that that referral being denied. It's because they're determined that they do have a family member to go home to that that person is able to actually take care of themselves. And so I guess the only rephrase the question, Do we see people that are coming into the MHU as being, like, people coming in and out of the MHU or they come in, they come in for seven days, seven to fourteen days, and then they don't return again?

Or are these people that are coming into the MHU and then they return to the MHU again on a regular basis? How often do we see people cycle in and out of the MHU? So

so usually, we the ones the cases that we refer are, individuals who are not getting better with, medication, that aren't turning the corner. And these individuals, in order to submit for conservatorship, we have to submit it on the ninth day of their fourteen day hold because we're only allowed to submit the application for conservatorship during that time. And individuals who, we submit for conservatorship are usually have been in and out of the hospital multiple times throughout the year so that we can determine that we have tried other options and we're not successful with their alternative options. Sometimes the individual will say, yes. I'm gonna go with my family, and then they go home, and then they're just the family is not able to support them.

And so they'll come back to the hospital. So those individuals, when we send them over for conservatorship, it's usually because they've been to the hospital several times and just need more support. Or as soon as they leave the hospital, they're no longer engaging in treatment or taking their medication.

Okay. Important,

if I may, supervisor, ask you to understand that the public guardian's law is obligated by law and statute to look for least alternative options other than the conservatorship. And so although we may have two doctors and and and it's important to also understand that that the MHU and the treating psychiatrist are looking through it at it from a different set of lens versus the public guardian's office. So we're looking more at the legal criteria versus the criteria and their acute needs that the doctor may be looking at a client who's being referred. So even though we have a client who, let's say this is their first time being referred, they are severely sick. They can't meet for their they can't provide for their own food, clothing, and shelter, but we have a viable source who's willing to help them.

By law, we have to allow that viable source to help them and not file for conservatorship.

Got it. A 100% that makes sense. And then one other question about the use of the emergency room. When it comes to, like, how long someone and I've know, we hear about the other hospitals. When we think about our our because the other hospitals in our region don't have an MHU, I don't believe.

Am I correct? So only two hospitals that have mental health units is, us and CHOMP. Salinas Valley does not have a mental health unit, neither does Maine Memorial. Okay. A little difference between us and CHOMP is that we are a locked unit, and they have what they consider a secure unit. Meaning that if the individual is trying to leave, they just need to push the door and the door will open. So they tend not to have individuals who want to leave. They'll look for an alternative placement.

Okay. So if we have someone who is waiting for placement and they're in our emergency they come in through the emergency room and we're full at our our unit. It's full. We're waiting for a bed to be opened up. How long will we will someone wait in an emergency room for a place for a bed to open in in our MHU?

That's really hard to say exactly. We we transferred over to the transfer center when we became a trauma unit. I actually went and trained all of the call takers at the transfer center. Since we've been with them, our patients get placed pretty quickly. At times, with our 18, they, at times, take longer to place depending on the needs of the individual and their age.

As you can see, the younger they are, it's a little bit more difficult to place because we have limited placement options. One of the biggest things that we asked with, AMR was the ability to ensure that we could still transfer some of our kids all the way to Bakersfield because they do, accept our patients who are younger and sometimes more difficult, to place. But it it really depends. Adults get placed pretty quickly, just depending on the day of the week and if it's full, at the other placements. But when San Jose Behavioral Health opened up, our placements are pretty pretty quick.

Okay. Matter of

time check. I I had another scheduled meeting at three. I moved that to 03:30, but I know we have three more items, and I gotta I gotta

We do. Yeah. Okay. No. Thank you. Thank you, supervisor. And then just one one final question on this one. So when someone's in the MHU and they are under conservatorship, are there lengths of stay? What's the the longest length of stay that someone can stay in the MHU?

Unfortunately, if they are requiring a state hospital bed prior to the recent changes, we've had individuals stay up to six to nine months, during COVID. We had one that stayed almost an entire year. It used to be very difficult to send individuals to the state hospital. You got on a waiting list, and you were basically competing for these beds with the entire state of California. Since the reforms and the changes at the state hospital, we have 11 beds, and I believe we can we have more or behavioral health has more liberty to, move individuals and put others in depending on who needs the bed and what the individual needs are.

Okay. Great. Well, thank you so much for the the report, and I really appreciate all of the information. I think it's important and really important area and for a whole group of folks that I think I need to make sure we're paying attention to the details of what happens here. It was just a receive a presentation. We'll do a public comment briefly. And then I'm just gonna ask if we could for the remaining three items where we have about fifteen minutes. If there's any of those items that need action from the board, if we could have those prioritized to go next, any one of them. I think they're all I'll let you guys prioritize those as we get public comment. Wes, did you have public comment on any on this item?

No. I'll pass. Thank you.

Okay. Is there any public comment anyone from the public who want to speak out on this item number two? We'll take public comment. We have Tim Haven online.

Tim Haven. Can you guys hear me?

Yeah. Thank you for joining us.

Tim Haven. Okay. Can still hear me?

Yes.

Tim Haven, I'm the chair of the lead. Many involved with the homeless. I just was curious. I I think you you were alluding to it, Wendy, but what the recidivism rate is, you know, if if there's any, you know, like, statistics or numbers on the recidivism rate, because I feel like there is a lot of recidivism. And, also, what the if there's, like, a a some sort of plan to get people into housing once they leave these facilities, I was really curious to learn more about that. But, yeah, that's all I wanna say.

Thank you for joining us. Thank you for always being engaged. Okay. So with that, we there's no action on this, and thank you for the information. I really appreciate the report again. We're gonna move on to Darby and the housing program team. Our next presentation is on the home investments partnership program funds. But Darby and Dawn, I'm gonna ask you guys, is there any of the next three items that needs action critical action from this committee in order to move forward?

Actually, all three of them.

All three of them. Okay. Yeah.

So I'm the presenter for all three. So

Okay.

I'll go as quick as I can.

Yeah. Let's do that.

Alright. So we'll start with the Home Investment Partnership Act. Darby Marshall. I'm with, Housing Community Development. Earlier this year in May, just as we were submitting our consolidated plan for the community development block grant to the board, we simultaneously got noticed that the county had finally reached eligibility for the Home Investment Partnership Act.

This is a grant program similar to CDBG, but specifically for housing issues. We were notified that we will receive, about $403,000 this year. We had to come up with some, matching funds to make the minimum grant 500. The state is allowing us to tap into some of the dollars that we hold from them. Because of the short timeline.

The reason this is urgent is we are taking this to the board on November 4, and I'm also going to the urban county committee at the end of this month. So, I'm here because this is a housing related issue, and I wanted to at least inform you of what our plans are for these dollars and get your input. With the home dollars, as I mentioned, we only have about 500,000 in new grant funds, plus another 112,000 in local funds that are required to match. We're proposing to use about 375,000 for what's called tenant based, rental assistance. Basically, that's the housing choice voucher program that the, housing authority administers.

It is portable by the tenant. So the the voucher goes with the tenant. They then have to find housing as opposed to project based, which if I if I had my druthers, I would give a certain number of tenants at Kent's Court vouchers so that I can make that project more viable. But these are are tenant based. And then the balance will be about 187,000 for housing rehabilitation.

I don't expect that to go far because our experience with housing rehab is it's then it's it is expensive. And because we don't have a lot of experience with these, what I'm probably gonna end up rec coming back to the board and recommending is that the $375,000 TBRA be forwarded to the housing authority for them to distribute as house housing assistance vouchers for income qualified households. And the city of Salinas is is starting up their housing rehab program again. And I'm thinking that if we could partner with them and use their their staff resources to, implement this program, we could probably do some good work in in around adjacent to Salinas. Again, we don't have a lot of money.

We only have $50,000 in admin for this. And so I think that if I can pay the city to get their inspectors out and to do the management that they're doing for their other rehab projects, there's probably a good return on investment there. So real quick, that's what we're planning to do with the home funds. I would welcome any input that you might have on these dollars and how we plan to use them.

Great. Thanks, Darby. And supervisor Alejo?

No. I'm I'm just good with the recommendation. Darby, it's not a whole lot of money, but well, we could partner with our folks who have have been in the trenches with us, the city of Salinas or housing authority, it makes sense, to get that out and put to good use shortly. K.

Yeah. So so, Demetri, just, I guess my my question, I'm I'm always, I guess, hesitant to to like, I appreciate I appreciate the idea of using of of rental assistance, but I'm also I recognize how quickly rental assistance disappears, and then it's gone, and we have nothing left to show for it. You know, we spent $50,000,000 in rental assistance during COVID, and I and and I guess I'd just be really interested in in knowing if there's there's other other critical needs that would allow us to to have something at at the end of the day that

So, yes, there are supervisor. One of the challenges, we had a very short window to to come up with our amended comp plan. And so I I did this quickly. We can change it next year and redirect the funds. Yeah.

Most places will use these as down payment assistance or housing rehabilitation. One of the challenges is the Fed set how much we can how much assistance we can provide and what the after assistance value of a unit is. And so it's been hard for us to use home dollars in the past in the unincorporated areas because the home values are just so high that we have a hard time qualifying people to get loans and then staying within the limits. Ideally, we would have multifamily projects that are coming in the pipeline. But, again, we just don't have any of those this year that are ready.

So I don't really have any place to put the money right away, but I also think we wanna try to capture it and make sure that we don't lose it in the future. But, yes, there are other things that will give us things at the end of the day, like rental multifamily rental projects or down payment assistance or housing rehab for income qualified households. It's just we have to have a critical mass of funding.

And and so okay, and so, like, the the Chasebud project that we're moving on East Garrison is not ready to go?

Correct.

And it has to be unincorporated county?

Right now, yes. It does. That's that's our challenge, is it has to be in the unincorporated areas. I'm really hoping that the project that is that Mid Penn is working on on Sill Road moves or Chiefs McCann accelerate, East Garrison, but I because I do have other money. I just I don't have projects right now, but I also don't wanna lose the opportunity to get money.

Okay. And, like, financing I'm sorry. Home repairs or improvements, like, we couldn't make money available for anyone that wanted to put an ADU up that was deeded low for for low income. I mean, I know we've got we've got ADUs moving forward throughout the county. People are people are making those available. They're building those right now. We've got people who want to add those to their properties.

I'm not

to fully fund it even.

So I'm not sure that part of this is the county has not had a home grant in over ten years. I think our last one was twenty I know our last one was in 2010, and I have not had a chance to read through the home final rule in its entirety. So I don't know the ins and outs of everything that is allowed. I I know generally that we can fund construction of housing. I know that we can fund rehabilitation, down payment assistance, tenant based, rental assistance, and how and and supportive services to help people purchase housing.

But in terms of being as specific as whether or not ADUs are allowed, I don't know the answer to that right now. And this is this is something that we will be doing research on and coming back as part of next year's consolidated plan or, excuse me, action annual plan and making recommendations for future years. But this is to just tie the funding up this year.

Yeah. Okay. I mean, I just if this is the if this is the the the best option, I I I'm I'll support what we've gotta do to to move forward. But, like, I would have I would have loved to see us find some way to say even if it's a way to, you know, to look into it a little bit closer or take a closer look at it, if there's any path to even if it's saying, hey, we'll put, you know, $50,000 or a $100,000 towards anyone who wants to get an ADU built and it It's a, you know, deed de restricted affordable so that we're adding we're actually adding more units. We're helping our county meet the arena goals, and we've got a long term additional unit in the county that's available.

I think I think those are the kinds of innovative solutions for adding something to show for for the for the for the long term that I would love to see us be be prepared to act on moving forward in some sort of creative outcome solution thinking. So, anyway, if there's a path to get to something like that, I would love to be supportive of that. If there's not a path to get to that and we've gotta just take action, I'm willing to back into that option, but that's reluctantly. Let's take it out

let's take it to public to get there.

Let's take it out to public comment. Tim, I see your hand raised.

Yeah. I would just probably refer this to Roxanne's department to collaborate with them. I mean, they're they're the experts in the county. Yeah. That would just be my suggestion would be.

Thank you, Tim. Is there any other public comment? Yes. We have Zee Boykin with her Henry's. I believe it's Zelika. Zelika? We'll call on Zelika. Can you hear me? We can. Thanks for joining us.

Yes, ma'am. First, I want to thank Darby for working with us on this and, trying to get these funds allocated to the housing authority. They will be a great resource for our tenants, and it will help the people that we currently have housed. And to speak to what he was saying about the money in the future and the housing authority, we have recently created a new CHOTO. It's called WISH Monterey College.

And, it'll be an entity that we could use for home funds on some of our developments, and we do have some plan for next year. So this will be something as to what you were speaking about, supervisor, ask you about the future projects and keeping affordable units and creating more. So we have taken steps to have that type of entity to have that available for funding for this, type of source next year. But I do agree with what he said this year, and I think we need to move on. And not only just because I'm the housing authority, but, with the current state of the government, if you don't use certain funds by a certain time, you kinda risk them recalling them back. So, again, thank you, Darby. I agree with everything you said, and we appreciate the assistance from the county.

Thank you, Zulika. Any other public comment? Roxanne Wilson has a comment. Great. Roxanne, thanks.

Will keep it very short. Number one, I am excited. This is the first time I heard that we're doing looking at TBRA as a as a a project, and I'm really excited because we all know that the cheapest way to address homelessness is to stop it before it happens. The only concern that I do have is the short term nature of it. So if we were to start a TBRA program, what happens to those individuals should the board decide to change our investments in the future?

So that's just something to really pay attention to. And, hopefully, there will be other vouchers made available, again, through the federal government when we do have those discussions. But I just wanna make sure we're paying attention to that so that we're not kind of leaving people in a bad situation by the end of this grant term. But great job, Darby.

I like it.

And, madam chair, I would these these funds, as Darby said, are for the unincorporated Monterey County, but I was also just in terms of getting more housing, if it would have been possible. Obviously, the the project home keys that we still haven't got across the finish line in Salinas, that would have been a help, but it obviously wouldn't qualify under that restriction. But that that's definitely would put some, additional units available to help those that were trying to to, get out of homelessness.

Actually, supervisor, we could do HomeKey. If the city of Salinas is putting is investing money into the project of their own Yeah. The federal regulations do allow us to invest home dollars in that community then. One of the one of the challenges is when we have the we have about $2,500,000 in home funds through the old through the state program. And even though they originated with the federal government, the state has placed an overlay that says that the county can only use it in the unincorporated areas.

Whereas the federal government regs say, if a jurisdiction invests, we can invest. So going forward, you know, HomeKey or or working in partnership with cities as long as they're bringing dollars to the table is certainly is certainly doable.

Right. Well well, I think we'll lean on Roxanne as as she's the one who's who finds the different funding sources to put together to get projects realized. So but, yeah, so I did wanted to mention that as a possibility. Thank you.

Yeah. Okay. So we've got a public comment. I guess you've got some direction and hesitation and hesitation about starting a new program that we don't necessarily want or we're not in a position to commit to continuing. You've got support for working with Zulika, but also a desire to see new units added with dollars that we bring into the the community, whether that's through HomeKey, through ADU development, and, like, not leaving money on the table.

So with some with some mixed feedback from the committee, see what you can pull together, and I guess this bring comes moves forward to the board.

Yes. It goes next to the urban county and then to the board, but I will incorporate these comments when it does get to the full board.

Thank you.

Got it. I think we move on next to the item four, rental income generated by Kent's Court, affordable housing presentation, and we've got Darby again.

That would be me. So Kent's Court, as you're aware, is a 16 unit county owned manufactured home project in Pajaro. The the property is deed restricted to being affordable to low income households. So, basically, households earning 80% of area median income adjusted for income size. The property was we never really had a a rent adjustment program in place.

And so we have households that are paying 20% of their income for housing and others that are paying 85% for housing. And that and neither of those are consistent with what state law for affordable housing is. And so what I am proposing is that we just implement state law and households are assessed rent based on 30% of their of their household income after a reasonable utility allowance. And the graphic I've put up shows gives you kind of an idea of what the incomes might be out there. I I some of these are, you know, some of these income bands, I only have one or two households.

I I'm saying these are averages. But you could see that some of these folks are gonna get some pretty big decreases in their rent and try to make it more affordable for them. Some of them, especially at the higher income levels, are gonna see some increases. And, you know, if if if that incentivizes them to move out and make that unit available for a a new low income household, I think that that is certainly a worthwhile objective. And the like I said, this will make things consistent with state law.

But because the county owns this, I did wanna bring it before this committee before I went to the board to see if you had any concerns about this this proposal with that that staff's presentation.

Supervisor Lehrer, thoughts?

Yeah. Initial thought, Darby, would be on just for those that would get a rent increase, would it be in compliance with state law that I think limits rent increases to 10%? Correct?

So because this this property has a deed restriction, we're actually exempt from, that state law, and I did have that verified by county council.

Mhmm.

So we we can make these rent increases. Yes. And they're still you know, they are still below the the housing authorities' fair market rents, which is what the housing authority what they would pay up to as a rent. So, you know, it's still a really good deal.

Yeah. Okay.

I'm sorry. So we we could we can we could make these so legally, we could make those changes. But is it how far so back to the question, though, is it out of line with the intent or the spirit of the the law?

I don't think So it is legal according to county council. Where the the question would lie is because these households are now making more than a 120% and in some cases making almost 200% of area median income, Is it right for do do we wanna continue to encourage them to remain at Kent's court when it's supposed to be income restricted to households making 80% of AMI?

No. No. I guess my question was charging making the change in the rent from what they currently pay to what this amount would be. Is that difference between what they currently pay and what you're proposing that they pay, is that more than the what the law would allow for if it wasn't technically legal?

Yes. It it is.

Okay. And what how many years would it take to get to, like, the half?

We would probably with these tenants, it would I haven't looked at that, but it would probably be quite some time. Okay. Because they are being pay charged such a below market rent right now.

Okay. So A three bedroom I think that yeah. So I think for that issue, I think I guess, if you're looking for feedback from us, I think one of my thoughts would be, you know, I think we would regardless of what's technically legal, I think we would wanna be conscientious to the reality for any family about, you know, pulling the rug out from underneath the them. If we were going to make any changes to the rent, I think it would need to be done in a way that tiered and planned out over a period of time so that people have with and then probably in align, I would think it would make sense to be in align with what the state has outlined for all other tenants. So as to give those families time to make plans that would be fair.

So those would be just sort of quick off the cuff thoughts. I wouldn't want to be to be to be to be coming into any particular family and saying, you know, we're going to we're going to, you know, cause you to have to suddenly make a bunch of changes because we've suddenly changed the rules in ways that that are that are unpredictable. But I do think that having having having the looking at the looking at the the intent of what Kent's court, you know, who we who we intend to serve and how we need to make sure the rents are fair. I think that it's a it's a good thing to look at and something that would be appropriate to do. The other thing that I think we're looking at and talking about and the city of Marina owns quite a bit of property on the former Fort Ord and is thinking also about, you know, how how rents should be considered and who they want to be who who they need to have like, where they need who they need housing for.

And there's a I I don't know what the what the what the de restriction for Kent's Court looks like. But, you know, if there the idea that the need for workforce housing and looking at who the employees are within the region that we do need housing for, if there's the ability or the option to have any of the Kent's court housing made available for any of the workforce that I know the county is looking at needing workforce for, that would be another question that I would just put out there. But I don't know that the deed restrictions that are in place allow for that to happen.

Supervisor, if if you would like, I can come back and using employment development department information, come back and give you an a presentation on the types of jobs that are in the county and what the median incomes are and how those fit into affordability to bands. I think you would be surprised at that at what we consider workforce because we really have to have a conversation about what how you wanna define workforce and and some of the underlying assumptions that we're gonna make about workforce housing. And so if you would like, I could come back with some of that basic data to at least help educate you in a former life. I spent a lot of time with that stuff, so I'm fairly familiar with it.

Yeah. No. I know it doesn't we don't qualify. It's not the definitions don't match up. I just want to

throw that

out there.

But it but it would be it might be helpful for you to to get a sense for the types of jobs, the number of people in those industries or in those particular jobs, and what the the median wages are. Because then we can have an in an informed conversation about how to design programs to meet those needs and identify where the gaps are.

Did you need direction on bringing

this So I have I do have some information that I will add to my board presentation on November 4. Darby I will try to address your question. Yes,

sir. Just on this, just thinking about it some more. Obviously, for those I I always look at this as one you know, some of these families have lived there for a long time, and and the tenants of the county of Monterey, they endured the flooding in 2023. And I know it doesn't generate a lot of income. I've even always asked ways to enhance the exterior just so it's more you know, just a nicer neighborhood setting with some landscaping and other amenities that could be added there, but I know we're we're limited on on what we generate from these rental units.

They're obviously important to those families, and it it makes sense for some of these those families that are gonna get a decrease in rent. Right? That makes sense. But like you're saying, the the rent's already pretty pretty reasonable considering the where the market's at. But I was just concerned about out of the 16 units, how many would get a rent increase? And 30 does seem pretty steep. Right? And I I don't wanna just say we're gonna increase it because we wanna encourage them to move out and allow others to move in. I would certainly be considerate to spread that over three years. Right?

If it's 30% and then 10 the maximum, which is the 10 of the law. Right? Max the state intends it to be tend to be reasonable, to do the same versus getting some of these families who have been there a long time coming to our colleagues who rise their church and saying, why are why are you increasing the rent so drastically to 30%, you know, upon giving be provided a notice. You know? So after I I I think we're gonna get to that point on why go there if we know it's gonna it's gonna cause some hardship on them, or we could spread it over three years.

But giving them the intent that it is gonna increase over time, but that this board is spreading it over three years to lessen the the adverse impact on them.

Supervisor, I think part of the the challenge is some of these households have lived there for a long time Mhmm. And they've had kids move out. Mhmm. So they now have a lot more extra income. And so we end up with, you know, three adults living in a three bedroom unit.

And and so we do need there is a you know, does that make sense? You know? So and I'm just looking at at and I just took a very legalistic view and said the state says that you could go to 30 or 35% based on how where they fit into the AMI tables. But I can certainly look at at spreading it over multiple years, but it it would also give us more financial flexibility to to do some of those improvements and make it a a more attractive property.

Yeah.

Well and the reality is it's it's literally impossible to find anywhere else to rent. I mean, it's still, like so, sure, 3030%. Great. Like, but you won't you cannot find anywhere else to rent that's gonna be 30% of your income. Like, good luck. Good luck with that. I mean, that's the reality. It's Yeah. So I I get the the catch 22 for folks.

It is. I'm just trying to I I used the 30% because that's what this law was, and it and it's the same percentage for everybody. Because some households are paying such a small percentage of their income versus others that are paying such a high percentage. So I will have some of this additional information for the board, and that's what I was looking for out of this session.

Right. And it would be helpful to get that instead of, you know, out of 16 Mhmm. You're gonna increase. Yeah. It would just help what what's the overall impact, and it'd help us to make make a decision that makes sense in terms of what what their increases will be from one year to the the following. Yeah.

Okay.

Okay. Is there any public comment on this item, hence court? I see none online. And then in the None. We're gonna move along. You've got some feedback from us.

Yeah. That was what I needed.

Okay. Perfect. And we're gonna go to item number five, a report and on the inclusionary housing ordinance. There's actually a lot here.

I know. And I've I've again, Darby Marshall. This is the inclusionary housing ordinance update. When we were last before the board at the June, we did commit to coming back and reporting by the October. So what I'm doing is a status report today, and I'm gonna do a full memo to the board kind of updating them.

But there are some critical path items where we do need guidance on how we wanna proceed. So no. No.

And I got fifteen minutes.

Yeah. Okay. So I'll skip the slides. So, basically, what we are proposing is that we look at adjusting the, inclusionary housing ordinance to make it so that it applies to all projects with seven or more rental units, making at least 8% of the units of, very low, 7% low, and 5% moderate. We wanna drop the workforce requirement for the time being because it's not inclusionary.

It doesn't help us with Rina. And there was a lot of ambiguity in the general plan policies in terms of when do you apply workforce one versus workforce two. We had no guidance on the term of affordability for the workforce units and the fact that the board released the first tranche of workforce units at the Commons at Rogue Road. And then we also had East Garrison Partners having trouble selling the the workforce units there. We'd like to have you direct us to analyze the general the 2010 inland general plan land use policies two eleven and two one three.

These are the affordable housing ordinance, and the development, evaluation system. The state has also told us, that because we never analyzed the the impacts that affordable that the workforce housing requirement had could have on the production of housing for all income levels that we cannot, enforce it at this time. So we do have that as as well. And then we also wanna get direction on developing a new in lieu fee, probably something that is more based on the cost to build a tax credit affordable unit. And then have us come back to the full board probably at the February with the findings of these analysis and final recommendations.

What we're looking at is promoting a housing development in from the general plan and the housing element planned growth areas, trying to increase and incentivize the development of affordable housing. Some of our policy and design questions are what's the appropriate project size? Is it three like it is now? Is it seven? At one point, it was one, or is there some other number?

What's the appropriate affordability requirement in distribution? Is it 10%, 15%, 20%, and eight seven five six six eight? What's the the right thing? And staff, we've we've come to believe that it's probably eight seven five. And then what is the appropriate timing for when affordable units are built or when alternative compliance requirements are are allowed and when they have to be met?

And then lastly, the affordability term. There's right now, we are looking at thirty years and forty five years and perpetuity for our ownership programs depending on where the project is located. We really need to streamline that. We need to assess what we really want out of it. And and do are we looking at making sure units are always affordable?

Are we looking at helping generate some, intergenerational wealth? How do you balance those? And then our with the six cycle housing element, the assumption that we've made is that, in general, we're gonna have 20% affordability, which is going to be a challenge. We have a balancing act. We have we wanna have affordable housing requirements that the the public sec the private sector is gonna meet.

But at the same time, state law says we cannot have requirements that are constrained to housing for all incomes. So if a developer were to come in and say, your inclusionary housing ordinance is constraining me from building market rate units, state HCD could agree with them or would come in and require us to do an analysis to demonstrate why it's not. We're also looking at a compulsory program, the inclusionary housing, ordinance versus a voluntary program like the density bonus that both of them are intended to help get us affordable units, but one is compulsory, one's voluntary. And it's really hard to incentivize the inclusionary housing ordinance because it's required. I mean, the the best incentive is is we would get rid of it from the developer's perspective.

Excuse me. So right now, the ordinance applies to, projects with three or more units. It's 20% affordability, and everything right now is restricted in perpetuity, which makes intergenerational wealth hard to, achieve. The development evaluation system applies to projects that are outside of, community areas or rural centers with five or more units, and it says 25% inclusionary and 10% workforce. It doesn't tell me if that's workforce one or two, and it doesn't tell me what that other 5% of inclusionary is.

Is it moderate? Is it low? Is it very low? So there's some challenges there. The affordable housing overlay is a challenge. It applies to all projects that wanna use that option, and it's a 100% affordable. And then we have the affordable housing ordinance. Again, applies to all new units, six six eight, and then a 5% workforce one, which we is not currently, enforceable. Statewide, the first inclusionary housing ordinance was adopted in 1979 up in Los Gatos. Monterey County joined the bandwagon in 1980.

Statewide, there are a 132 mandatory inclusionary housing programs. On average, they trigger at eight units, and the average affordability for those is 14.36%. So just about 14% of the units are gonna be affordable to, usually low and very low households. Additionally, there are 82 mandatory linkage or impact fee programs, and, typically, they require a payment of a fee equal to about 10% of the proposed units. I do have some information.

I'll have to put this up, for the board. It goes into how things are distributed and what it how it works. One of the things that I I do wanna explain is we run off what's called the waterfall. We have a waterfall. So if you are have to produce, an odd number of very low income units, we roll that fractional unit to being a low income unit, and any fractional unit there goes to moderate.

Any remaining fractional unit, the developer can either turn into a unit or pay a fractional in lieu fee. We could also reverse that and say, there's a fractional moderate, it goes to low. Fractional low goes to very low. The advantage to that would be it increases the percentage of very low and will almost always automatically trigger density bonus concessions or additional units for the developer if that's what they're after.

Sorry. I'm gonna interrupt just so because I I know I've gotta leave. We both gotta call at 03:30 just to make sure we so I know we're this is coming is this also coming on November 4 to the board?

Is not. This is this is just going to be a memo to the board. Okay.

To start with?

Yeah. But I I I go back in and because I'm gonna have to spend more money on consultants. I I need to know, am I are we on the right track with what we wanna analyze in terms of affordability distributions? And and what kinds of considerations would you want us to look at for in lieu fees and how we calculate the in lieu fees.

Mhmm. I

I think before we spend I mean, I'll just jump in. I think before we spend more money on consultants, I think we do need to have a conversation with the board. And the other comment or question I'm gonna put put out there is, you know, I don't know if this is something that the planning commission considers or has discussed, but I think it would be worthwhile to have a conversation with the planning commission and get some feedback and engage in a, you know, a dialogue. But I'll pass it over to supervisor to see if you have additional thoughts.

Yeah. I I think I think we need some more, a full discussion with the board. Right? Because some of these, Darby, are kind of slight changes, right, from the seven eight five, and now you're saying maybe eight seven five is better. It's like, changing that 1% from the very low category to the or low to the very low, and then removing the workforce.

What does that what does that mean, down the road in terms of our approval process? The in lieu fee is always an interesting discussion because I always, always say that what we get now for in lieu doesn't really help us build much, you know, when when they could be free from that responsibility, and they give a payment that really is it's a it's a nominal amount compared to what it really takes to actually build the the unit. So and and then, obviously, the the the the deed restrictions on the perpetuity, that's another big discussion there, versus the alternatives of 30 thirty years, as well because I I know we dealt with that with Morocco, for those families that got a settlement that left that restriction in perpetuity and and really making it difficult when they're trying to pass that that, those assets to their children down the road. So these are all all key topics, but I think it's one that merits a discussion among the five supervisors.

If I may, how much time do you think I should ask for for this topic? I mean, we we went, like, ninety minutes at the June Yeah. When I when I kinda laid the groundwork. But do I need another ninety minutes in December or or January, or what do you think?

I I think we need to I think we need to, like, lay the questions out very specifically. I mean, I think there's the the the the there's the information, I think a memo that goes out, and I think maybe having some one on one conversations with each office in advance Right. Will give you a good sense of where everyone's at in advance of coming, and we'll help you then know which issues are gonna need the conversation and where the where the question points are. And I think you can do some of that legwork, you know, like, kind of like, some of the questions. Right?

Like, do you know, is it is it is it thirty years, or is it in perpetuity? Like, you're gonna know. Like, that's a that's a question of, like, is, like, that's a that's a count to three kind of question where you're gonna know where the answer is after having conversations. But then you just lay that out. That's a that's a like, I need direction on question a, question b, question c. And I but it's gonna be a one on one. I think I think make the rounds before

Hopefully, you know what other jurisdictions are doing too, Darby. Right? And and some of this some of the question, where do other cities stand? Where do the Santa Cruz County or SLO? San Jose? Let us put this discussion in context of what are other counties are what are they currently doing, and has it helped them advance housing construction, and addressing some of these key questions. It it it would just be helpful look looking at what our neighbors are doing.

So I did have information on, how other inclusionary programs are structured. That was all in attachment a.

I'm just gonna do another quick time check. I know we've gotten a call. So so I'm gonna do I'm gonna open this up to public comment to see if there's any public comment on this item. Is there anyone with us for public comment on this inclusionary housing ordinance item if you're with us and wanna make public comment?

There are no public comments.

Okay. I don't see any hands raised either. So we'll close public comment on this item. We'll bring it back just so we can wrap it up. We've got one final minute to close out. Any other final comments, supervisor Alejo?

I like the doing the one on ones with Darby and the supervisors in advance to that next meeting. I think it would save time, but also, allow the one on ones, just honing in on those on an individual basis, I think, would be helpful to the larger discussion, Darby.

Okay. I will do that.

Yeah. And then, you know, and then I think it is something that's, like, it's gonna require some conversation, but getting it getting really getting really clear about what the question what the questions are that we need direction on from from what the next steps are.

Okay. So for me.

Okay. Awesome. Thank you. With that, we are going to close this meeting. Thank you all for your patience with the extended conversation about the mental health unit. Our next meeting is scheduled for I don't know when.

This is the last last

of the year. This is our last meeting of the year. Thank you all for your for participating in our extended presentations about all of our departments this year. I know I learned a lot. And thank you all to the staff. Thank you, Roxanne, for taking the leadership and organizing everything this year. I don't know who's gonna be taking over for for stopping us next year, but we appreciate all of the support. And we'll see you all next year. Thanks. Thank you.