DATE: May 1, 2018
TO: Board of Supervisors
SUBMITTED BY: Delfino E. Neira, Director, Department of Social Services
Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Agreement with Central Star Behavioral Health, Inc. for Senate Bill 163 Wraparound Services
RECOMMENDED ACTION(S):
TITLE
1. Hear and consider appeal from Uplift Family Services regarding recommended award of the Agreement for wraparound services to Central Star Behavioral Health, Inc.
2. Approve and authorize the Chairman to execute an Agreement with Central Star Behavioral Health, Inc. for wraparound services, effective June 1, 2018, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed, $22,500,000.
REPORT
Should your Board deny the appeal of Uplift Family Services, it is recommended that your Board approve and authorize the proposed agreement with Central Star Behavioral Health. Both the County Administrative Officer (CAO) and the Purchasing Manager have reviewed and considered the appeal from Uplift Family Services pursuant to the County’s appeal process and recommended that the appeal be denied.
Approval of the recommended action will allow Central Star Behavioral Health to provide wraparound services to children and families involved with the Department of Social Services’ (DSS) Child Welfare System. The cost ($22,500,000) is offset with Medi-Cal Federal Financial Participation (FFP), Behavioral Health and Mental Health Realignment, and Senate Bill 163 (SB163) funds, with no Net County Cost.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the second recommended action is not approved, dependent children and their families will no longer receive intensive, family-centered, wraparound services. While the mental health services component for children and families involved would continue to be provided through contracted providers, the provision of intensive, family-centered wraparound services makes it possible for participating dependent children to remain at home or in lower-levels of care.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the agreement ($22,500,000) will be 100% offset using a combination of Medi-Cal FFP, Behavioral Health and Mental Health Realignment funds, and SB163 Wraparound funds. Sufficient appropriations and revenues will be included in the FY 2018-19 Recommended Budgets for DSS Org 5610 and Department of Behavioral Health Org 5630. Sufficient appropriations and revenues will be included in all applicable subsequent requested budgets for both departments.
DISCUSSION:
DSS, in partnership with the County’s Departments of Behavioral Health (DBH) and Probation, have contracted to provide wraparound in Fresno County since 2005. The Departments work collaboratively to ensure optimal service delivery that aligns with, and positively impacts, the safety, permanency, and well-being of children and families. Wraparound services have been provided in an effort to improve outcomes for Foster Care, Probation, and Adoption Assistance Program eligible youth at risk of escalating into, or remaining in, higher level placements, such as group homes.
On May 19, 2015, your Board approved an agreement with FamiliesFirst, Inc., dba EMQ FamiliesFirst for provision of wraparound services in Fresno County. EMQ FamiliesFirst has since changed their name to Uplift Family Services. Uplift Family Services has been providing wraparound in Fresno County since 2005.
Since May 19, 2015, an average of 94 Fresno County children and their families received wraparound services each year. Each youth was in, or at risk of being in, the highest service needs level (rate classification level 10 to 14). Currently, program services are delivered by Uplift Family Services to a contracted capacity of 150 youth.
On November 9, 2017, Request for Proposal (RFP) #18-015 was released to more than 30 agencies. DSS and DBH requested proposals that presented comprehensive strategies to provide wraparound services. These services are in compliance with Katie A. Settlement Agreement (Katie A.) mandates and will allow for consistency with a family-centered practice model designed to improve outcomes for youth.
Four (4) agencies submitted proposals: Central Star Behavioral Health (Central Star), Mental Health Systems (MHS), Uplift Family Services (Uplift), and Westside Family Preservation Services Network (WFPSN). An RFP Review Committee comprised of representatives from DSS, DBH, Probation, and a community-based organization evaluated and ranked the proposals. The committee unanimously ranked Central Star at the highest ranking, followed by Uplift, MHS, and WFPSN.
Evaluations were based on the following award criteria: bidder company data that demonstrated experience and capacity to provide the requested services; comprehensiveness of the response, consistency with the intent of the RFP; demonstrated organizational readiness to provide the services; and a completed cost proposal that demonstrated a proposed budget that is in the County’s best interest.
The Central Star proposal demonstrated a strong understanding of the requested services, experience providing wraparound services in other California counties, and the organizational readiness to provide the requested services expeditiously. Central Star met all requirements of the RFP and offered more services than the minimum requested at the same cost; therefore, the review committee recommended they receive the award. The additional services were deemed a benefit to clients and cost-effective for the County.
The Uplift proposal demonstrated extensive experience, however, was ranked lower in comparison to the proposal submitted by Central Star. The committee identified several concerns regarding the Uplift proposal, including but not limited to: minimal post-service transition, insufficient outcome measures, staffing configuration issues that would impact service delivery, and the cost proposal was deemed to be “top heavy” and not in the County’s best interest. These issues were identified by reviewers when comparing Uplift’s proposal to Central Star’s. No significant concerns were identified in the Central Star proposal.
The review committee’s conclusion was presented to the DSS Director and he concurred with their unanimous decision. A tentative award notice was sent out on February 13, 2018.
On February 14, 2018, Uplift submitted a request to view the bids. As all award notices are tentative, Purchasing denied the request as it is County policy not to release bids until after award.
On February 22, 2018, Uplift submitted an appeal to the Purchasing Manager on the following grounds:
1. The funding decision was based on information that was not solicited in the RFP;
2. The reviewer’s comments and scores were inconsistent with language in the award funding recommendation;
3. Due process was compromised by the scoring process not being conducted in a manner that provided measurable ratings; and
4. Uplift did not have access to documents necessary to prepare a fully-informed appeal.
On March 5, 2018, the Purchasing Manager denied the appeal on the basis that the review committee concluded the proposal submitted by Central Star was the best overall proposal that met the requirements of the RFP and the review process, including information on the ranking evaluation process, was outlined for bidders at the bidders’ conference.
On March 13, 2018, Uplift appealed to the CAO on the same basis as above. The CAO agrees with the Purchasing Manager and concludes that there is no reason to change the tentative award recommendation. The appeal was denied by the CAO on March 20, 2018.
DSS recommends that the Uplift Family Services appeal be denied by your Board. The points raised by Uplift do not support a change in award. The review committee unanimously recommended Central Star for full award and the Department concurs with this recommendation. The Central Star proposal addressed every component solicited in the RFP and offered additional services at the same cost as the Uplift proposal, thus providing a more cost-effective program for the County and more beneficial services for County clients. Therefore, it is recommended that your Board award the agreement to Central Star.
Central Star will serve a contracted capacity of 150 youth at any given time. Discussions with Central Star and the incumbent vendor, Uplift, have been initiated to assure a transition plan will be in place prior to June 30th, to assure the least disruptive transition for youth currently enrolled with Uplift.
If approved, the recommended agreement will begin on June 1, 2018 through June 30, 2021 with two optional one-year extensions under the same terms and conditions, unless Central Star, the County, the DSS or DBH Directors or designees provide written notice of non-renewal not later than 60 days prior to the close of the current term. The services and maximum compensation amounts provided in the recommended agreement are contingent upon the availability of funds and can be amended to reduce the maximum compensation at any time during the contract period. The agreement may be terminated without cause by either party upon providing 60 day advance written notice.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement
On file with Clerk - Advance Agenda Materials
CAO ANALYST:
Ronald Alexander