DATE: June 18, 2019
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
Delfino E. Neira, Director, Department of Social Services
SUBJECT: Master Agreement for Child Welfare Mental Health Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a Master Agreement with providers of Child Welfare Mental Health Services for individuals in the Child Welfare Services System, effective July 1, 2019, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $80,000,000.
2. Authorize the Directors of the Department of Behavioral Health and Social Services, or designees, to add and/or delete providers or reallocate funding within the Master Agreement with providers of Child Welfare Mental Health Services.
REPORT
Approval of the first recommended action will ensure children and families involved with the Department of Social Services (DSS) Child Welfare Services system receive mental health services in compliance with Katie A. Settlement Agreement (Katie A.) mandates and will allow for consistency with a family-centered, community-based practice model designed to improve outcomes for children in foster care.
Approval of the second recommended action will allow for the addition and/or deletion of providers and funding reallocation, as necessary, within the Master Agreement to meet service needs, without exceeding the annual contract maximum. The recommended Master Agreement will be primarily offset by Medi-Cal Federal Financial Participation (FFP) and Mental Health Realignment revenues, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the first recommended action is not approved, children and families involved in the DSS Child Welfare Services system who are currently receiving court-ordered specialty mental health services and/or requiring services in the future may experience a gap and/or delay in services. Non-approval of the second recommended action would require the Department to return to the Board each time there is a change in service need requiring the addition and/or deletion of a provider and/or fund reallocation.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The maximum amount of the recommended agreement ($80,000,000) will be fully offset with Medi-Cal FFP, Mental Health Realignment, and 2011 Child Welfare Realignment. Sufficient appropriations and estimated revenues will be included in the Behavioral Health Org 5630 FY 2019-20 Requested Budget and in future budget requests for the duration of the contract.
DISCUSSION:
The Department of Behavioral Health (DBH) and the Department of Social Services (DSS) have been working collaboratively towards the provision of specialty mental health services for children and their families involved in the DSS Child Welfare Services system. The goal of this collaboration is to contract with one or more community-based providers to meet the mental health needs of this population, consistent with State-mandated Katie A. requirements, now known as the Pathways to Mental Health Core Practice Model, and the California Integrated Core Practice Model. The Board executed agreements for outpatient specialty mental health and court-specific services on July 29, 2014 with Mental Health Systems (MHS) and Central Star Behavioral Health, and on September 22, 2015 with California Psychological Institute and Uplift Family Services. On June 20, 2017, the Board executed a Master Agreement to supersede the prior separate agreements for these services, which expires June 30, 2019.
On December 27, 2018, a Request for Proposal (RFP) 19-036 was released to 747 vendors registered in Public Purchase who met the classification match; 487 of which were located in California. In response, four (4) agencies submitted proposals: California Psychological Institute (CPI), Central Star Behavioral Health (Central Star), Uplift Family Services (Uplift), and Turning Point of Central California (Turning Point). After evaluating the proposals, the RFP Evaluation Panel recommended funding of the proposals submitted by CPI, Central Star, and Uplift. The Evaluation Panel determined that these three proposals were the most responsive and advantageous to the County.
If the recommended agreement is approved, CPI, Central Star, and Uplift will provide outpatient specialty mental health services and court-specific services to children and their families involved in the Child Welfare Services system. The majority of the clients served have high-acuity needs and require long-term services. In FY 2017-18, 3,044 unique clients were served among three vendors with 59,585 services rendered and 625 clients discharged successfully with all treatment goals met. In the first nine months of FY 2018-19 (July 2018 through March 2019) 2,658 unique clients were served among three vendors with 47,877 services rendered. During this nine-month timeframe, 537 clients were discharged successfully with all treatment goals met.
The recommended agreement allows for changes to services, staffing, and responsibilities of the contracted providers, to accommodate changes in the laws relating to specialty mental health treatment, as well as changes to the budget’s expense category subtotals that exceed 10% of the individual provider’s total annual maximum compensation, may be made after review and approval by County Counsel and Auditor. Additionally, the DBH Director is allowed to approve changes in service sites, budget expense category subtotals that do not exceed 10% of the individual contractor’s total annual maximum compensation, volume of units of services/types of service units to be provided, service rates, and changes to the maximum compensation amounts payable to each provider. These changes ensure the necessary flexibility in budget and capacity for providers to be able to hire staff appropriately and meet capacity needs for children and families, without a gap or delay in services. Both the DBH and DSS Directors would be able to add and/or delete contractors, based on service need, and approve the individual provider’s term extension for each additional twelve-month period, based on satisfactory performance. Modifications approved by the DBH and/or DSS Directors shall not result in any change to the total combined maximum compensation payable to all providers under this Master Agreement, without returning to the Board for approval.
If approved, the recommended agreement will become effective July 1, 2019 and may be terminated by the County, DBH, or DSS Directors, or designees, or the contractor(s), upon providing a 60-day advanced written notice.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended Master Agreement at its May 15, 2019 Board Meeting.
REFERENCE MATERIAL:
BAI #50, June 20, 2017
BAI #7, September 22, 2015
BAI #29, June 6, 2015
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Master Agreement for Child Welfare Mental Health Services
CAO ANALYST:
Ronald Alexander