Mountain View-based mental health services nonprofit Community Health Awareness Council (CHAC) announced that its clinic services will be going on hiatus beginning in August due to a currently insurmountable budget deficit.
The nonprofit’s school-based operations and family resource centers – services used by thousands of community members annually – aren’t going anywhere, Interim Executive Director Anne Ehresman emphasized in an interview with the Voice. Only CHAC’s in-house counseling services at its Mountain View clinic on El Camino Real will be impacted by the change.
As part of the Santa Clara County Board of Supervisors next budget, approved June 15, $1 million in funding will be on its way to CHAC as soon as possible -- financial support that Ehresman said will be immensely helpful as CHAC navigates its uncertain future. But the organization needs more than one-time funds, she said.
“If we’re going to create anything that’s long term, we have to make it sustainable and not just spend all the money in one shot, and be in the same place 10 months from now,” Ehresman said. “We’re eager to understand what the contract’s going to look like (with the county), and what that will mean for the services that we’ll be able to restore.”
Decision to halt clinic services
When Ehresman joined CHAC earlier this year as interim executive director following Marsha Deslauriers’ retirement, she said it was clear there was a fiscal deficit and crisis that the organization needed to address.
“We tried to look at as many immediate options as possible to keep all of our services intact,” Ehresman said. “But as we were building the budget for the next fiscal year starting July 1, we had to make some hard choices.”
Much of CHAC's work consists of school-based services, which include counseling, prevention programs and social emotional learning at local schools. Those programs are funded in partnership with the schools they serve, Ehresman said, hence why they’re not impacted by the organization’s budget woes. Similarly, CHAC’s family resource centers, which offer programs to help parents and caregivers navigate the social-emotional development of their kids, are funded through FIRST 5 Santa Clara County and won’t see any adverse impacts in the near future.
“I’m happy that those two pieces are stable,” Ehresman said. “When we looked at where we were not stable and where we do not have enough resources, the clinic just did not have enough of a revenue stream attached to it.”
Ehresman said the clinic typically sees around 400 clients a year, with 40 to 50 receiving low-cost therapy at any given time. Following the tough decision to shut down its clinic, CHAC will be working to connect its current clients with other mental health care resources between now and Aug. 1, the clinic’s hard stop date. In the interim, the clinic will not be accepting any new clients.
“The really hard thing is that we’ve had to tell people who are calling for our services that we can’t accept them, and we are not maintaining a waiting list,” Ehresman said. “That part is heartbreaking and really hard, because there are people who are in need of care, and CHAC has been a very affordable, trusted provider for them.”
Length of hiatus and possible solutions
In addition to the $1 million from the county in the pipeline, Ehresman said there are other opportunities on the horizon that could allow the clinic to resume discontinued services, including partnerships with other organizations.
“We have been talking with lots of other behavioral health providers in the community,” she said. “None of us want to have an empty building on El Camino. We want to try to have services be available for folks that are affordable.”
While this type of partnership hasn’t yet come to fruition, Ehresman said she’s hopeful that it might in the next six months or so. Such a collaboration could take a number of different forms, like leasing out part of CHAC’s space to another provider, or members of CHAC’s staff combining forces with another provider’s staff to restore some level of clinic service for the community, Ehresman said.
“Things are on the horizon, they just don’t line up nice and neat with the fiscal calendar that starts July 1,” Ehresman said. “So that’s why this decision needed to be made.”
In the long term, Ehresman said CHAC’s clinic services need to become more financially sustainable. One way for that to happen is to make the organization eligible for Medi-Cal funding and reimbursements for services it provides.
“We have to look at the lift that it would take in order for us to be qualified to receive Medi-Cal,” Ehresman said. “That doesn’t happen with the snap of a finger. It could take up to a year or longer.”
District 5 county Supervisor Joe Simitian, who pushed for CHAC to receive the $1 million county funding contribution, is a strong supporter of this long-term solution.
“The county will work with CHAC to try to ensure that CHAC can make itself Medi-Cal eligible,” Simitian told the Voice. “That is the means by which CHAC can be reimbursed for the services they provide, and that is the essential element of making sure that they’re financially secure as they provide these services in the future.”
The process to become eligible for Medi-Cal reimbursements goes through the state Department of Health Care Services, and begins with an application, Simitian's office told the Voice.
“I think they’re clearly at a place where they’ll want to have some conversations about governance and structure,” Simitian added. “Times change, funding systems change, the regulatory environment changes. I applaud CHAC for recognizing that their model and structure needs to evolve in order to keep serving county residents.”
Ehresman said that as hard as it was to put CHAC’s clinic services on hiatus, it does offer the organization something of a blank slate to figure out its future.
“We’re in a period of discovery, and we’re in a period of pain, honestly. Nobody likes these decisions,” Ehresman said. “The clinic is the place where we’ve got to really put this attention and energy to figure out solutions that aren’t just Band-Aids and duct tape, but are long-term, good answers. That will be a lot of the reflection and discernment process that we’ve begun and we’ll continue over the next six to 12 months.”