DATE: June 9, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Amendment III to Agreement with Turning Point of Central California, Inc. and Master Agreement for Adult Full Service Partnership Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment III to Agreement A-15-215 with Turning Point of Central California, Inc. to extend Adult Full Service Partnership Services by three months from July 1, 2020 through September 30, and increasing the maximum compensation by $1,086,345 to a total of $21,939,381.
2. Approve and authorize the Chairman to execute a retroactive Master Agreement with various providers for Full Service Partnership Services to adults and older adults, effective June 1, 2020 through June 30, 2025, which includes a 3-year and one-month base contract and two optional one-year extensions, total not to exceed $84,382,479.
REPORT
Approval of the recommended actions will allow the Department to continue to provide Full Service Partnership (FSP) services including comprehensive mental health services including housing, education, and community supports. The first recommended action will allow for a 3-month expansion of these current services, as provided by Turning Point of Central California, Inc. (Turning Point), which will allow adequate time for another program site to be prepared by the current provider and to include a new provider, Mental Health Systems, Inc., under the recommended Master Agreement. Some delays were experienced due to the COVID-19 pandemic; therefore, additional time is needed to ensure minimal impact to adults who are currently receiving services from Turning Point. The proposed Amendment will extend the original five-year term for an additional three-month period and will increase the maximum compensation by $1,086,345. All other terms of the Turning Point Agreement will remain the same, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, there will be a minimal service transition period which may delay or otherwise negatively impact the adults served. If the Master Agreement is not approved, termination of these services could result in homelessness, incarceration or increased need of public assistance and other services including hospital emergency departments and law enforcement for both the impacted clients and potential clients.
RETROACTIVE AGREEMENT:
The second recommended action is retroactive to June 1, 2020 in order to begin the 3-month ramp up period of the new FSP Program Sites under the recommended Master Agreement, so that services may begin effective September 1, 2020. Delays were experienced due to the COVID-19 pandemic.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The cost of the recommended three-month extension is $1,086,345, which will increase the maximum agreement compensation from $20,853,036 to $21,939,381. The cost of the recommended Master Agreement will be $84,382,479, for a 3-year base term and two optional 12-month extensions; there are no services pending. Both of the contracts identified within this agenda item will be fully funded by various sources including, but not limited to: Medi-Cal Federal Financial Participation, client rent revenue, and Mental Health Services Act funds (Community Services and Supports).
Sufficient appropriations and estimated revenues for the recommended Amendment III and the Master Agreement will be included in the FY 2020-21 Recommended Budget of the Department of Behavioral Health Org 5630 and in all applicable subsequent recommended budgets throughout the term of the Master Agreement.
DISCUSSION:
On June 2, 2015, your Board approved the Agreement with Turning Point to operate the Full Service Partnership (FSP) services, called “VISTA”, for up to 300 individuals with a diagnosis of a serious mental illness (SMI) and who are homeless, at risk of being homeless, involved in the criminal justice system, or a frequent user of hospital and/or emergency room services as the primary resource for mental health treatment. The FSP program(s) encompasses a unified team approach, in which the provider commits to do “whatever-it-takes” and “meet the client where they are” to assist the individual to reach their personal recovery, resiliency and wellness goals and aim to reduce the number of days of hospitalization, incarceration and/or homelessness. Services are provided on a voluntary basis, 24/7, with a case manager to client ratio of no more than 1:15. The adults are referred to the service provider through various entities including the client’s physician or community programs and are approved for services by the Department of Behavioral Health (DBH) Urgent Care and Wellness Center.
On February 2, 2016, your Board approved the Amendment I to Agt. No. 15-215 which allowed Turning Point to utilize DBH’s current electronic health record, “Avatar”. Effective March 1, 2020, your Board approved the Amendment II to Agt. No. 15-215 which allowed for flexibility in the budget modification language due the COVID-19 pandemic. The adjustment allowed for budget modification requests of up to 20% of the maximum compensation. This change allowed Turning Point to have more flexibility with the budget modification process to purchase additional technological items or personal protective equipment for their staff who may have already expended all funds in a specific line item or expense category to, all without an increase to the maximum compensation.
On November 18, 2019, the Department released RFP #20-026 requesting proposals from qualified vendors to operate up to four Full-Service Partnership Program Sites, providing comprehensive mental health, housing, education and community supports with a continuous service capacity for a total of 720 adults with a SMI diagnosis. The following three agencies responded to RFP #20-026: Turning Point of Central California, Inc.; Mental Health Systems, Inc.; and Kings View Behavioral Health. There was also an additional bid that was deemed unresponsive by the Purchasing Manager.
The Evaluation Panel was comprised of four (4) members consisting of the following representatives: DBH Mental Health Clinician, DBH Utilization Review Specialist, DBH Fiscal Analyst, and DBH Principal Analyst. All four voting members attended the panel evaluation meeting on February 6, 2020, where they discussed and evaluated each proposal based on the requirements of the RFP.
DBH informed the Evaluation Panel that only three FSP Program Sites would be operating during Year 1 (FY 2020-21); therefore, it was recommended by the panel collectively that Turning Point operate two Programs Sites of no more than 180 clients per site and Mental Health Systems operate one program site of no more than 180 clients at any given time. It was also agreed by consensus that DBH shall evaluate both Turning Point and Mental Health Systems when it is time to ramp up for the fourth FSP Program Site. The final Program Site will be awarded to the agency that can demonstrate the best performance outcomes. Purchasing concurred with the Evaluation Panel’s recommendation.
Transition of adults between the two Turning Point program sites will begin June 1, 2020; however, due to the intense needs of the adults with SMI, there is a need to make the transition as smooth as possible. If approved, the recommendation Amendment III will extend the current Agreement with Turning Point for an additional three-month period to provide sufficient time to ramp up the new Program Sites and transition currently enrolled adults between the two Turning Point’s Program Sites and the new Mental Health Systems’ Program Sites with minimum impact to existing individuals served.
If approved, the recommended Amendment III will be effective upon execution through September 30, 2020, with the same terms and conditions. The recommended Master Agreement, if approved, will become effective retroactive to June 1, 2020 through June 30, 2023 with an option for two additional 12-month periods based upon successful performance by the Contractor(s). The Master Agreement may be terminated by County or the DBH Director, or designee, or one or more Contractor(s) upon the giving of sixty (60) days advance written notice of an intention to terminate.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended Master Agreement on April 22, 2020 via email communication and was informed of the recommended Amendment III in May 2020 also via email communication.
REFERENCE MATERIAL:
BAI #31.1, April 28, 2020 - Agt. 15-215-2 with Turning Point of Central California, Inc.
BAI #17, February 2, 2016 - Agt. 15-215-1 with Turning Point of Central California, Inc.
BAI #32, June 2, 2015 - Agt. 15-215 with Turning Point of Central California, Inc.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment III to Agt. No. 15-215 with Turning Point
On file with Clerk - Master Agreement for Adult FSP Services
CAO ANALYST:
Ronald Alexander