DATE: November 5, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Master Agreement for FSP Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment I to Master Agreement No. 23-287 with Mental Health Systems, Inc. and Turning Point of Central California, Inc. to include Community Assistance, Recovery and Empowerment Act court petitioning and services, effective upon execution, with no change to the term of July 1, 2023 through June 30, 2025, and no change to the maximum compensation of $40,531,492.
REPORT
There is no additional Net County Cost associated with the recommended action, which will allow the Department of Behavioral Health (Department) to provide services consistent with the Community Assistance, Recovery and Empowerment (CARE) Act, which provides community-based behavioral health services and supports to Californians living with untreated schizophrenia spectrum or other psychotic disorders through a new civil court process. Approval of the recommended action will update the scope of services to include CARE Act services and allow the County to meet the State-mandated CARE Act implementation deadline of December 1, 2024. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the Department will be out of compliance with Welfare and Institutions Code (WIC) Section 5970.5(b), which mandates CARE Act services begin no later than December 1, 2024.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. CARE Act services are fully funded by various sources, including the Department of Health Care Services’ (DHCS) CARE Act Reimbursable Activities funding, Medi-Cal Federal Financial Participation and Mental Health Services Act funds (Community Services and Supports). The total maximum compensation of $40,531,492 for the Agreement is unchanged, Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Approved Budget.
DISCUSSION:
On June 9, 2020, your Board approved Master Agreement No. 20-216 with Turning Point of Central California, Inc. and Mental Health Systems, Inc. (MHS) to provide Full Service Partnership (FSP) services including comprehensive mental health services including housing, education,
and community supports.
On June 20, 2023, your Board approved Master Agreement No. 23-287, which superseded Agreement No. 20-216, for FSP services for California Advancing and Innovating Medi-Cal required updates including payment structure changes.
On September 14, 2022, Senate Bill (SB) 1338, known as the CARE Act was passed into law. The CARE Act requires counties to establish a new civil court process designed to connect individuals with specific mental health diagnoses with needed services and support coordinated and/or provided by county behavioral health departments under the oversight of a judge through a one-year process. WIC Section 5970.5(b), as amended by SB 1338, requires that a second cohort of counties, representing the remaining population of the state, begin providing CARE Act services no later than December 1, 2024, unless the county is provided additional time. Fresno County is part of the second cohort.
Approval of the recommend action will update MHS’ Scope of Work to include CARE Act services related to the petition process and services for individuals who are approved for CARE Act. Services related to the petition process include providing notice to individuals for whom a CARE Act petition has been filed on their behalf, outreach and engagement to connect individuals to services, and provide a written report to the Court regarding an individual’s eligibility, outcomes of the outreach and engagement, and protected health information to support recommendations in the report. For individuals who are approved for CARE Act services, FSP level of care will be provided which includes services such as individual and group therapy, medication supports, peer support services, transportation and housing supports.
The proposed amendment will allow the County to be in compliance with WIC Section 5970.5(b) by the December 1, 2024 deadline by leveraging MHS’ established track record as a contracted provider for FSP services in Fresno County, along with their experience with the CARE Act petition process and providing FSP services for CARE Act eligible individuals in first cohort counties such as San Diego.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended action at its October 2024 meeting.
REFERENCE MATERIAL:
BAI #45, June 20, 2023
BAI #19, June 9, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Master Agreement No. 23-287
CAO ANALYST:
Dylan McCully