DATE: August 19, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 2 to Agreement with Iran Barrera for Evaluation Services for California Reducing Disparities - Evolutions Innovation Pilot Project
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 2 to Agreement No. A-22-566 with Iran Barrera for evaluation services for the California Reducing Disparities - Evolutions Innovation Pilot Project, revising compensation from budget line-item reimbursement (hourly-rate) to milestone-based payments, with no change to the term of December 13, 2022, through December 31, 2026, or compensation maximum of $380,000.
REPORT
There is no increase in Net County Cost associated with the recommended action. Approval of the recommended action will allow the Department to reimburse this evaluator based on contract deliverables which will bring reimbursements in line with project timelines. The services are funded with Mental Health Services Act (MHSA) Innovation (INN) funds, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the Department would be at risk of not completing all evaluation requirements per MHSA INN regulations. The evaluation is vital to determine if the pilot program is viable, sustainable or should be eliminated.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The cost for all services ($380,000) will be funded with MHSA INN funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2025-2026 Recommended Budget and will be included in subsequent budget requests throughout the duration of the term of the Agreement.
DISCUSSION:
On April 13, 2021, the Board approved the Department’s MHSA 2019-2020 Annual Update and 2020-2023 Three-Year Plan which included the development of a new proposed MHSA-INN pilot project: California Reducing Disparities - Evolutions.
On December 13, 2022, the Board approved Agreement No. 22-566 for the evaluation of the California Reducing Disparities Project (CRDP) - Evolutions Innovation (INN) Pilot Project.
On January 18, 2022, the Board approved of the Department’s Agreements with The Fresno Center, West Fresno Health Care Coalition d.b.a. West Fresno Family Resource Center, and Integral Community Solutions Institute for the California Reducing Disparities - Evolutions Innovation Pilot Project. The project would examine three Fresno area programs (Hmong Helping Hands Program, Sweet Potato Program and Atención Plena and Pláticas Program) to adapt these from community defined practices to support culturally specific populations in a manner that will align with MHSA Prevention and Early Intervention (PEI) funding criteria and outcome measures. The identified programs would provide strategies to reduce disparities that exist among underserved populations in the public behavioral health systems.
On June 18, 2024, the Board approved Amendment No. 1 (No. 24-301) to extend the term of the agreement to continue the evaluation of the CRDP programs, and to increase compensation for the extended term.
MHSA INN’s component provides California counties the opportunity to develop, test, pilot, adapt, and research new or unproven mental health models. Each county’s MHSA budget sets aside 5% for INN projects. The primary purpose of these projects is to achieve an increase to access, quality, interagency and community collaborations related to mental health services or supports or outcomes.
The Mental Health Services Oversight and Accountability Commission regulations require all INN plans to have an evaluation component to assist in analyzing effectiveness and program feasibility. Dr. Iran Barrera will develop a tracking and reporting system to gather and analyze data, advise on data collection, provide organized reports, and assist in communication of findings. In addition, the evaluation will focus whether the programs can be adapted to meet legislative funding requirements and whether the programs can increase access to mental health services and increase the quality of mental health services to underserved groups.
Should the evaluation prove the pilot program to be effective, the Department will evaluate options and make future program decisions based on data and information yielded from the program and evaluation.
Approval of the recommended action will revise compensation from budget line-item reimbursement (hourly-rate) to milestone-based payments for the remainder of the term of the Agreement. The evaluation activities provided through this agreement are tied to program timelines. These programs conduct data collection activities based on program cycles, which leads to periods of increased or decreased activity for the evaluator. By changing the compensation method to milestone-based payments, the evaluator will be able to reduce administrative burden and increase the focus on in-depth evaluation and program outcomes. Compensating the evaluator upon completion of specified work deliverables will ensure the County receives a high-quality evaluation in exchange for the allocated funding.
REFERENCE MATERIAL:
BAI #41, June 18, 2024
BAI #18, January 18, 2022
BAI #39, December 13, 2022
BAI #37, April 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 2 to Agreement with Iran Barrera
CAO ANALYST:
Ronald Alexander Jr.