DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Suspension of Competition Agreement for Multi-Agency Access Program (MAP)
RECOMMENDED ACTION(S):
TITLE
1. Under Administrative Policy No. 34 for competitive bids or requests for proposals, determine that an exception to the competitive bidding requirement is satisfied and a suspension of competition is warranted due to unusual or extraordinary circumstances, and that the best interests of the County would be served by entering into an agreement with Centro La Familia Advocacy Services, Kings View, and Poverello House for the continued operation and success of the County’s Multi-Agency Access Program; and
2. Approve and authorize the Chairman to execute an Agreement with Centro La Familia Advocacy Services, Kings View, and Poverello House for the operation of the Multi-Agency Access Program, effective on July 1, 2024 through June 30, 2026, total not to exceed $2,200,000.
REPORT
There is no additional Net County Cost associated with the recommended actions. The recommended actions will allow the Department of Behavioral Health (DBH), in partnership with the Department of Social Services (DSS) and Department of Public Health (DPH), to continue providing uninterrupted services through the Multi-Agency Access Program (MAP). This item is countywide.
ALTERNATIVE ACTION(S):
If the Board does not approve the recommended actions, DBH would need to discontinue providing MAP services to persons in need in Fresno County.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
It is requested that the County find under Administrative Policy No. 34 (AP 34) that an exception to the competitive bidding requirement is satisfied, and a suspension of competition is warranted due to unusual or extraordinary circumstances as DBH, the vendors, and other partnering County departments adjust to changes to Mental Health Services Act (MHSA) funding availability resulting from the passage of Proposition 1, and continue the collaborative work toward fiscal sustainability and integration with other Managed Care Plans under CalAIM without reducing or ending services provided to individuals and families through MAP. The Internal Services Department - Purchasing concurs with the Department’s assessment that this satisfies the exception to the competitive bidding process required by AP 34.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum cost of the agreement ($2,200,000) will be fully funded by DSS, DBH, and DPH. The initial term of the agreement will be $1,100,00 for the first year; and $1,100,000 for the last year. DSS will fund $200,000 of costs per year through Supplemental Nutrition Assistance Program (SNAP) Employment and Training (E&T) funds from the United States Department of Agriculture (USDA) Food and Nutrition Service (FNS) funds. DPH will fund $100,000 of cost per year through Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) grant funds, while DBH will fund $800,000 of costs per year through MHSA Prevention and Early Intervention (PEI) funds. Sufficient appropriations will be included in the DSS FY 2024-25 Recommended Budget for Org 5610; the DBH FY 2024-25 Recommended Budget for Org 5630; and in the DPH 2024-25 Recommended Budget for Org 5620. Each department will include sufficient appropriations in future budget requests.
DISCUSSION:
The MAP program was developed and implemented as a pilot program in 2015 to address the difficulty for individuals and families in Fresno County to reasonably navigate, access, and receive necessary services. The Board approved Agreement No. 17-006 on January 10, 2017 for DBH to fund and monitor the MAP program, as well as the subsequent amendments: Agreement No. 22-252 on June 21, 2022 and Agreement No. 23-267 on June 20, 2023, which decreased budget maximums and extended the contract term through June 30, 2024. Your Board also approved Agreement No. 23-594 on November 7, 2023 to authorize the use of the last contract year (July 2023 through June 2024). In January 2022, DBH adopted the Unite Us Platform to house the MAP Community Screening Tool, which is used to assess the needs of the person served and guides MAP staff and persons served on a service action plan, and collects and reports individual and program activity and demographics.
The MAP services and Unite Us Platform have previously been funded by MHSA PEI funds; however, with the passage of Proposition 1 in March 2024, MHSA funding will be reallocated to different service categories; thereby significantly reducing allocations for MHSA PEI programs. Because there is overlap in the individuals and families served, DBH has partnered with DSS and DPH to leverage resources for a more sustainable blended funding plan for MAP.
In the first year of the recommended agreement, the parties involved will develop a plan for the next iteration of MAP. The parties would take into consideration the results of an external evaluation of MAP conducted by the RAND Corporation in October 2022, the current program, funding and service options (including Enhanced Care Management through Managed Care Plans), and other viable strategies. The Probation Department has also expressed interest in collaborating with the current partners on this agreement and will be included in planning conversations. DBH intends to return to your Board to amend the agreement to revise the scope of work and budget to include Probation Department funding resources and necessary programmatic changes. In the second year of the agreement, the parties will implement the plan decided upon in the previous year. Additionally, DBH will initiate a request for proposal for ongoing MAP services or an equivalent program designed in the first year.
The recommended agreement is a collaborative partnership between the Departments of Behavioral Health, Social Services, and Public Health that involves blended funding to maintain support for MAP services to persons in need in Fresno County.
The Modification clause in the recommended agreement deviates from the County’s standard agreement language by allowing the DBH Director to make non-material changes to the scope of work with the approval of County Counsel and the Auditor-Controller/Treasurer-Tax Collector (ACTTC), and allows the DBH Director and DSS Director to authorize changes to expense category subtotals up to 10% of the maximum compensation. The modification clause further allows the DSS Director to revise the scope of services for the sole purpose of recategorizing CFET activities to meet funding requirements, through an amendment approved by County Counsel and ACTTC. Additionally, the agreement allows the DSS Director to authorize reductions in CFET funds due to funding availability to no more than 20% of the total CFET compensation with no change to the scope of services.
REFERENCE MATERIAL:
BAI #47, November 7, 2023
BAI #39, June 20, 2023
BAI #36, June 21, 2022
BAI #37, June 22, 2021
BAI #28, January 10, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition
On file with Clerk - Agreement for Multi-Agency Access Program
CAO ANALYST:
Dylan McCully