DATE: September 21, 2021
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Agreement with Fresno County Superintendent of Schools and the Fresno Police Chaplaincy’s Resiliency Center - Handle with Care Plus
RECOMMENDED ACTION(S):
TITLE
1. Make a finding that is in the best interest of the County to suspend the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances as the Fresno County Superintendent of Schools and the Fresno Police Chaplaincy’s Resiliency Center are local government agencies and the sole, unique vendors to provide rapid trauma response services for the Department of Behavioral Health’s innovation project;
2. Approve and authorize the Chairman to execute an Agreement with the Fresno County Superintendent of Schools and The Fresno Police Chaplaincy’s Resiliency Center, for piloting a mental health innovation project to provide and evaluate the effectiveness of rapid response to traumatic experiences for youths 4-11 years of age, effective upon execution through June 30, 2024, total not to exceed $1,061,460; and,
3. Approve and authorize the Department of Behavioral Health Director, or designee, upon review by County Counsel as to legal form and Auditor-Controller/Treasurer-Tax Collector as to accounting form, to approve minor changes to program services and budgets, as needed, to accommodate changes in the laws relating to mental health treatment, with no change to the maximum compensation.
REPORT
There is no increase in Net County Cost associated with the recommended actions. Approval of the recommended actions will allow for the utilization of Innovation(INN) funds received by the Department of Behavioral Health from the Mental Health Services Act (MHSA) to implement a pilot project with the Fresno County Superintendent of Schools (FCSS) and the Fresno Police Chaplaincy’s Resiliency Center for the rapid response to youth after a trauma or a life changing event. The third recommended action will allow the Department Director, or designee, to approve minor changes to the program and funding reallocation, as necessary, and without exceeding the total maximum compensation. This item pertains to locations in Districts 2 and 3.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended actions, the approved MHSA INN plan and funds would not be implemented, and the ability to provide and evaluate a rapid response program for children who experience a traumatic or life changing event would not be conducted and the funds would revert back to the state.
SUSPENSION OF COMPETITION/SOLE SOURCE CONTRACT:
The Department of Behavioral Health’s request to suspend the competitive bidding process consistent with Administrative Policy No. 34 results from the fact that FCSS is a governmental agency encompassing many of the school districts, charter schools, and schools within the County. FCSS is advantageous to coordinate care with all school districts countywide, which would assist in expanding the program. Also vital to the pilot project is the Fresno Police Chaplaincy’s Resiliency Center’s unique technology application that tracks real-time service calls, including situations that may involve children and life changing incidents. The Internal Services Department - Purchasing Division concurs with the Department’s request to suspend the competitive bidding process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum compensation for the recommended agreement is $1,061,460 and will be financed with MHSA INN funds. Actual costs will not exceed $341,539 for FY 2021-22. Sufficient appropriations and estimated revenues are included in the Behavioral Health Org 5630 FY 2021-22 Adopted Budget and will be included in future budget requests for the duration of the contract.
DISCUSSION:
The MHSA INN component provides California counties the opportunity to develop and test new unproven mental health models with the potential to become tomorrow’s best practices. The primary purpose of INN projects is to achieve an increase to access, quality, interagency and community collaborations related to mental health services or supports or outcomes.
On May 28, 2020, pursuant to MHSA INN regulations, the Department presented three INN programs to the Mental Health Services Oversight and Accountability Commission (MHSOAC) for approval to expending INN funds. The proposed programs were vetted through the stakeholder process and plans were posted for a 30-day public commenting period. Approval was granted from the MHSOAC with the contingency of formal local Board adoption/approval to move forward with next planning steps for the proposed programs.
On July 7, 2020, your Board approved moving forward with development of the three proposed MHSA INN projects: The Lodge, Handle with Care Plus, and Project RideWell. Currently, each program is at a different stage of development.
Approval of the recommended action will allow the Department to move forward with implementing the Handle with Care Plus in accordance with the INN plan approved by your Board and the MHSOAC. Handle with Care Plus will create a cross sector program that will respond to children and families immediately after a trauma or stressful life event. Traumatic events can include, but are not limited to, violence in the home or community; loss of loved ones through divorce, death, incarceration, and other separations; and any major life changes from natural disasters, accidents, and other life altering incidents. The focus is to provide early support, screen and assess children for early indicators of mental health symptoms, empower the family with tools they need to cope and recover, and connect children and families to any additional necessary resources. Additionally, Handle with Care Plus will have an evaluation component to measure the outcomes of a rapid trauma response team and determine if a psychoeducational parent café component can assist in reducing the effects of trauma on children and their families.
The proposed agreement is a three-year pilot project to provide early intervention and support services to children between the ages of 4-11 years old of varying ethnicities, and generally from lower socio-economic backgrounds, who have traditionally been underserved by the behavioral health system. The target population was selected via data analysis from the Fresno Police Chaplaincy, which identified high volumes of traumatic events, and a need for resources for the youth and families attending four elementary schools -- Heaton, Del Mar, Pyle, and Lowell, all in the Fresno Unified School District. The overall concept is to identify these young students and inform their school to “handle them with care” and provide extra attention to their behaviors immediately after experiencing a traumatic event, to prevent any tragedies or decrease in wellness.
Additionally, the innovative element of this project is the inclusion of two Parent Cafés which will provide psychoeducational support and resources for the whole family so they can recover and normalize together. The Parent Cafés will have a strength-based curriculum and framework that emphasizes physical, psychological, and emotional safety and help support resiliency in the community. The Parent Cafés will be staffed with peer professionals to relate and encourage families to participate in the targeted eight-week strength-based, family centered, and trauma informed curriculum developed specifically for our local communities.
The recommended agreement allows for changes to services, staffing, and responsibilities of FCSS and The Resiliency Center, as needed, to accommodate changes in the laws relating to mental health treatment, via review and approval by County Counsel and Auditor. Additionally, it would allow the Department Director to approve changes in service sites and budget expense category subtotals that do not exceed 10% of the contractors’ total annual maximum compensation. These changes ensure the necessary flexibility in budget and capacity for contractors to be able to hire staff appropriately and meet capacity needs, without a gap or delay in services. Modifications approved by the Director shall not result in any change to the total maximum compensation payable to the contractor under the recommended agreement.
In addition, there is inclusion of mutual indemnity and hold harmless language in this agreement. Due to the partnership between the Department, FCSS, and The Resiliency Center, with Risk Management and Counsel’s review, the Department is allowing mutual indemnity and hold harmless language as there is a need for these efforts for both parties and the risk is very minimal.
The recommended agreement is a three-year contract with FCSS and The Resiliency Center from the date of contract execution to June 30, 2024. This pilot project will be evaluated by the MHSOAC at the end of the term for ongoing support and/or funding.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board has reviewed and approved the INN plan for Handle with Care Plus on April 9, 2020.
REFERENCE MATERIAL:
BAI #31, July 7, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
Suspension of Competition Acquisition Request - FCSS
Suspension of Competition Acquisition Request - FPD RC
On file with Clerk - Agreement with FCSS and RC - Handle with Care Plus
CAO ANALYST:
Sonia M. De La Rosa