DATE: December 11, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Agreement with Uplift Family Services, Inc. for Assertive Community Treatment for Children/Youth
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute an Agreement with Uplift Family Services, Inc., for the provision of Assertive Community Treatment mental health and community services supports for children and youth ages 10 to 18 years with serious emotional disturbances, effective January 1, 2019 through June 30, 2023, which includes a two-year and six-month base contract and two optional one-year extensions, total not to exceed $12,997,313.
REPORT
Approval of the recommended action will allow for the provision of an Assertive Community Treatment (ACT) program designed to deliver comprehensive mental health and community services and supports to children and youth ages 10 to 18 years with serious emotional disturbances and/or co-occurring disorders with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There are no alternative actions. Should the recommended action not be approved, there will be an interruption in mental health services for approximately 160 children and youth.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum cost of the recommended agreement ($12,997,313), will be funded with Mental Health Services Act (MHSA) Community Services and Supports funds and Medi-Cal Federal Financial Participation (FFP). Sufficient appropriations and estimated revenues ($1,349,259) are included in the Department’s Org 5630 FY 2018-19 Adopted Budget and will be included in subsequent budget requests for the duration of the contract term.
DISCUSSION:
Under the provisions of the Mental Health Services Act (MHSA), also known as Proposition 63, County mental health departments have received funding to assist in providing services to underserved and unserved populations through new or expansion of existing programs. The Department conducted a mandated local community stakeholder process to identify highest service needs of the County and accordingly allocate MHSA Community Services and Supports funds to meet those needs. The recommended agreement will allow the Department to provide an Assertive Community Treatment (ACT) program for up to 160 children and youth ages 10 to 18 years of age who have serious emotional disturbances (SED).
On June 3, 2013, your Board approved an agreement with Uplift Family Services, Inc. (Uplift) for the provision of a full service partnership (FSP) level of services to children ages 10-18 with serious emotional disturbance (SED) and at least one diagnosis from the current Diagnostic and Statistical Manual of Mental Disorders (DSM) utilizing the Assertive Community Treatment (ACT) model. ACT provides strength-based and client-driven services focused on stability in the community and achieving identified goals, using evidence-based practices. ACT emphasizes relationship-building and active involvement in assisting individuals with severe and persistent mental illness to improve functioning, better manage symptoms, achieve individual goals, and maintain optimism. Uplift provides service coordination, on-call (24/7) crisis assessment and intervention, symptom assessment and management, psychiatric services (including medication and medication management), dual diagnosis, individual or group therapy, case management, social and leisure-time skill training, peer support, supportive services, education, consultation, and court participation.
This agreement was amended in 2017 to expand the services to caregivers to optimize the youth's ability to reach wellness and recovery and amended in 2018 to extend the agreement for six months to provide time to complete an RFP.
A Request for Proposal (RFP) 18-044 was issued on April 10, 2018 and closed on May 17, 2018. The Department received two bids: Mental Health Systems, Inc. and Uplift Family Services, Inc. (Uplift). A review team consisting of Staff Analysts from the Department’s Clinical Program Support, Business Office and Internal Services Department, a Licensed Mental Health Clinician and Utilization Review Specialist from the Contract Services Division.
The Department’s recommendation is based on Uplift’s proposal meeting the County’s RFP service requirements, fiscally sound budget, organizations capability and understanding of the MHSA Community Services and Supports component, acknowledgement of a Full Service Partnership and familiarity with MHSA State requirements, experience and knowledge of the ACT program, demonstrated outcome measurements, and financial stability and use of funds for program sustainability.
The recommended agreement would serve a minimum of 160 unduplicated clients at any given time. In addition, identified clients’ siblings, other relatives, caregivers, and other significant support person may receive specialty mental health services from this program. The program will be evaluated on an annual basis as to the capacity of clients to be served. The program services will be delivered by three multi-disciplinary teams with a staff to client ratio of 1:8 allowing more effective mental health services to meet client needs. Operational program hours will be 24 hours, seven-days per week, with frequent face-to-face contact. Teams will be comprised of a team leader, mental health clinician, addiction counselor, education/vocation specialist, family specialist, and one psychiatrist for total program services.
Services under the recommended agreement will include, service coordination, crisis assessment and intervention, symptom assessment and management, psychiatric services (education training, medication and medication management), co-occurring disorders, individual/group therapy, case management, rehabilitation and family support, social interpersonal relationship, peer support, client support services (non-treatment such linkage to primary care, transportation, social services etc.), educational services, and consultation with behavioral health court, families, and other major supports.
The recommended agreement allows the Director to terminate without cause with 60-day advance written notice, authorize budget line item changes that do not exceed ten percent (10%) of the total annual contract amount.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended agreement at its November 21, 2018 Board Meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement
CAO ANALYST:
Ronald Alexander