The County of Santa Clara
California

Agreement/Amendment
101060
Approved as Amended
Jun 23, 2020 9:30 AM

Consider recommendations relating to Fiscal Year 2020-2021 Short-Doyle and Mental Health Services Act contracts.

Information

Department:Mental Health Services (Santa Clara Valley Health and Hospital System)Sponsors:
Category:Appropriation Modification (4/5 Roll Call Vote)

Attachments

  1. Printout
  2. Amend 3-Abode-FY20-21 for BOS Signature
  3. Amend 2-BWC AOA-FY20-FY21 for BOS Signature
  4. Amend 2-Caminar F&C-FY20-21 for BOS Signature
  5. Amend 2-CCSCC F&C-FY20-21 for BOS Signature
  6. Agreement-Chamberlains-FY21 for BOS Signature
  7. Amend 2-FFYC F&C-FY20-21 for BOS Signature
  8. Amend 2-GFHN CJS-FY20-21 for BOS Signature
  9. Amend 2-HR360 F&C-FY20-21-for BOS Signature
  10. Amend 2-Starlight AOA-FY20-21 for BOS Signature
  11. Amend 4-Seneca-FY20-21 for BOS Signature
  12. Attachment 1-SD-MHSA Solicitations List
  13. Attachment 2- SD-MHSA Contracts History
  14. Attachment 3- SD-MHSA FY 2021 Summary of Changes for Renewal Amendments
  15. B5Y--BWC-AOA-OP- FY21- Approved
  16. B5Y-CMH-F&C-OP-FY21-Approved
  17. B5Y-CCSCC-F&C- First 5-FY21-Approved
  18. B5Y-CCSCC-F&C-Kindred Souls-FY21-Approved
  19. B5Y-CCSCC-F&C-OP-FY21-Approved
  20. B5Y-FFYC-F&C-TBS ID-FY21-Approved
  21. B5Y-GFHN-CJS-FSP, OP, CDCR Integrated, AB 109 FSP-FY21-Approved
  22. B5Y-HR360-F&C-OP-FY21-Approved
  23. B5Y-SFA-F&C-OP, IOP, ES OP, TBS-FY21-Approved
  24. Chamberlains-STRTP-Single Source-Approved
  25. FFYC-STRTP-Single Source-Approved
  26. Seneca- SLS UE-Single Source-Approved
  27. Seneca-Pro-CSR-Single Source-Approved
  28. Seneca- EITFC-Single Source-Approved
  29. Seneca-ISS-Single Source-Approved
  30. Seneca-ITFC-Single Source-Approved
  31. Seneca-TFH-Single Source-Approved
  32. Seneca- TWC-Single Source-Approved
  33. Agreement-Amend 2-Abode-SHS-FY20
  34. Agreement-Amend 1-BWC-AOA-FY20
  35. Agreement-Amend 1-Caminar-F&C-FY20
  36. Agreement-Amend 1-Catholic Charities-F&C-FY20
  37. Agreement-Amend 1-FFYC-F&C-FY20
  38. Agreement-Amend 1-GFHN-CJS-FY20
  39. Agreement-Amend 1-HR360-F&C-FY20
  40. Agreement-Amend 1-Starlight-AOA-FY20
  41. Agreement-Amend 3-Seneca-F&C-FY20
  42. Final Revised Amend 4-Seneca-FY20-21 for BOS Signature

Multiple Recommendations

Possible action:
a. Approve Third Amendment to Agreement with Abode Services relating to providing supportive housing services, increasing the maximum contract amount by $5,135,523 from $4,295,857 to $9,431,380, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality.
b. Approve Second Amendment to Agreement with Bill Wilson Center relating to providing adult and older adult services, increasing the maximum contract amount by $1,460,163 from $1,460,163 to $2,920,326, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
c. Approve Second Amendment to Agreement with Caminar for Mental Health relating to providing family and children services, increasing the maximum contract amount by $2,500,544 from $2,500,544 to $5,001,088, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
d. Approve Second Amendment to Agreement with Catholic Charities of Santa Clara County relating to providing family and children services, increasing the maximum contract amount by $3,096,890 from $4,150,821 to $7,247,711, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
e. Approve Agreement with Chamberlain's Youth Services relating to providing family and children services in an amount not to exceed $821,520 for period July 1, 2020 through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. A single source exception to competitive procurement has been approved by the Office of Countywide Contracting Management pursuant to Board of Supervisors Policy 5.6.5.1(D)(2)(a).
f. Approve Second Amendment to Agreement with Fred Finch Youth Center relating to providing family and children services, increasing the maximum contract amount by $482,214 from $492,912 to $975,126, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
g. Approve Second Amendment to Agreement with Gardner Family Health Network relating to providing criminal justice services, increasing the maximum contract amount by $3,960,182 from $3,960,182 to $7,920,364, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
h. Approve Second Amendment to Agreement with HealthRight 360 relating to providing family and children services, increasing the maximum contract amount by $2,668,114 from $1,189,508 to $3,857,622, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
i. Approve Fourth Amendment to Agreement with Seneca Family of Agencies relating to providing family and children services, increasing the maximum contract amount by $16,883,411 from $13,846,002 to $30,729,413, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality. An exception to Board of Supervisors Policy 5.4.5.4, Length of Term of Contracts, has been approved by the Office of Countywide Contracting Management.
j. Approve Second Amendment to Agreement with Starlight Community Services relating to providing adult and older adult services, increasing the maximum contract amount by $653,865 from $653,865 to $1,307,730, and extending the agreement for a 12-month period through June 30, 2021, that has been reviewed and approved by County Counsel as to form and legality.

Body

FISCAL IMPLICATIONS

Funding for these contracts are included in the Behavioral Health Services Department’s (BHSD) Fiscal Year (FY) 2021 Recommended Budget.

BHSD SD/MHSA Medi-Cal contracts include one or more of the following funding sources: California Department of Corrections and Rehabilitation; CalWORKs; City of San Jose; City of Palo Alto; City of Mountain View; Behavioral Health County General Fund; FIRST 5 of Santa Clara County; Measure A; Medi-Cal Federal Financial Participation; Mental Health Services Act (MHSA); Projects for Assistance in Transition from Homelessness (PATH) Grant; Santa Clara County Probation Department; Santa Clara County Social Services Agency; San Andreas Regional Center (SARC); State Realignment; AB 109 Public Safety; Substance Abuse and Mental Health Services Administration (SAMHSA); Proposition 47; Homeless Mentally Ill Outreach and Treatment (HMIOT); and the U.S. Department of Housing and Urban Development (HUD).

CONTRACT HISTORY

BHSD Short-Doyle (SD)/MHSA Agreements are master contracts that contain other behavioral health services. These programs were awarded through the competitive solicitations and single source approvals listed in Attachment 1- SD-MHSA Solicitations List. Beyond Five Year requests that were approved by the Office of Countywide Contracting Management (OCCM) for specific programs exceeding a five-year term are also described within Attachment 1- SD-MHSA Solicitations List.

The execution of each original Agreement and subsequent Amendments for the vendors listed in the recommended actions are described in Attachment 2- SD-MHSA Contracts History.

REASONS FOR RECOMMENDATION

The recommended actions would approve FY 20-21 contracts for BHSD SD/MHSA providers to continue delivering behavioral health services to Santa Clara County beneficiaries through June 30, 2021. A description of the programs delivered by each provider, the increases to their maximum financial obligations to cover FY 20-21 services, addition of new programs, and any other additional updates are outlined in Attachment 3- SD-MHSA FY 2021 Summary of Changes for Renewal Amendments.

Abode Services’ new Leigh Avenue Senior Supportive Services Program would help seniors obtain and maintain permanent housing by assisting with rental application processes, appeals, and making referrals to services that would facilitate tenancy (e.g., job training, employment services, social support networks, and transportation). Services would also include conducting assessments to identify the client’s needs, eligibility for entitlement programs, and self-sufficiency. Access to primary care, specialty care, dental care, and behavioral health services would also be included for this target population. The program aims to reduce subjective suffering from mental illness, enable clients to have a safe and stable home environment, and increase access to permanent jousting, behavioral health services, and networks for supportive relationships.

Chamberlain’s Youth Center and Fred Finch Youth Center’s new Short-Term Residential Treatment Programs (STRTP) would provide intensive mental health services, including strengths-based assessment and treatment planning, medication evaluation and supportive services, crisis intervention, individual, group, collateral, and family therapy, case management/intensive case coordination, and rehabilitation to youth who cannot be placed through presumptive transfer. Services must be provided in a manner that supports the maintenance of the youth’s permanent connections to include family where appropriate in treatment and support the successful transition back to a home-based setting in Santa Clara County. The providers would work in collaboration with BHSD, the Social Services Agency, and the Probation Department to ensure that the needs of youth and their families are being met.

HealthRight 360’s new Transitional Aged Youth (TAY) Interdisciplinary Service Teams (IST) would provide office-based clinical and non-clinical services to TAY clients at a location that may include community-based sites such as community colleges, youth-friendly spaces, or a County funded and/or County operated multi-cultural wellness space. The target population are clients ages 16-25 who need supportive services, crisis intervention, and linkages to treatment services. TAY IST is designed to be a lower level of mental health care compared to intensive programs such as an Intensive Outpatient Program (IOP) or Full Service Partnership (FSP) program, and would consist of case managers, licensed or licensed-waivered clinicians, psychiatrists, substance use treatment services counselors, and peer support. Services would be provided in a safe, welcoming, and inclusive atmosphere to increase the chances for successful outreach, engagement, and direct access to behavioral health resources.

Seneca’s new Therapeutic Visitation Services Program would provide therapeutic supervised visitation for children/youth and their family members. Youth involved with this service are Dependents of the Court, as described by Welfare and Institutions Code, Section 300 in Santa Clara County, or in proceedings to possibly become Dependents of the Court and have experienced trauma and significant child abuse or neglect. The goal of services is to provide therapeutic coaching and support to enhance and strengthen the dyadic relationship during a supervised visit between youth and parent. The program would build and enhance parenting skills and improve the parent-child relationship. Following successful completion of the therapeutic supervised visitation services, the youth and family are expected to transition to one of three outcomes, depending on the safety and risk assessment completed by the Department of Family and Children’s Services’ (DFCS) supervising social worker: 1) traditional supervised visits, 2) monitored visits, or 3) unsupervised visits, as directed by the Court and supervising social worked.

Seneca would also add five additional programs that would provide services to children and youth to address any service gaps resulting from the Receiving, Assessment and Intake Center (RAIC) closure in FY 19-20. These programs include The Welcoming Center (TWC), Immediate Stabilization Services (ISS), Intensive Treatment Foster Care (ITFC), Enhanced Intensive Treatment Foster Care (EITFC), and Transitional Foster Home (TFH).

TWC would provide comprehensive, intensive, culturally competent, and trauma-informed mental health services to clients with complex mental health needs and behavioral that require the level of care provided in intensive resource family homes. TWC’s staff would be specialty-trained counselors who attend to the client’s physical, emotional, and mental health needs (including crisis de-escalation interventions) in a home-like environment. All services would promote a calm and stable environment while the client’s needs are assessed, and the best possible placement is secured.

ISS is designed to provide in-person intervention in the community. Services also include triage phone support services for clients as preventative interventions. The goal of ISS is to intervene early in situations that could escalate to crisis levels. This type of early intervention would focus on the stabilization of clients in their living situation to avoid disruption in placement. Time to access initial services should not be more than two to three hours from the time of referral. ISS would include licensed clinical staff that can provide supervision and capacity to respond 24 hours a day, seven days a week. Clients under this program shall be provided with support services that include therapeutic stabilization and crisis de-escalation to support planned permanency, wellness and recovery.

ITFC are home-based placements that would allow caregivers to provide clients with individualized mental health treatments. ITFC homes are a higher level of care than regular resource family homes (formerly called foster homes). ITFC homes would be located in Santa Clara County to allow for connections to ongoing natural supports, including family relationships and treatment providers. ITFC would provide in-home treatment to support stability, safety, and improve client well-being by integrating an ITFC level of care and specialty mental health services. EITFC serves clients with acute and intensive behavioral and mental health needs (e.g., aggression and self-harm). EITFC are a higher level of care than ITFC and would also be located in Santa Clara County to allow connections to ongoing natural supports, such as family relationships and treatment providers.

TFH would provide home-based placement options with caregivers where treatment needs can be individualized for each youth. This program would serve children and youth with behaviors and mental health needs that interfere with immediate placement with family or kinship relations. There is an emphasis on care coordination and interventions to support children and youth that have been removed from the home and have an acute reaction to separation from caregivers. TFH would provide in-home treatment to support stability, safety, and improve well-being for each child or youth by integrating specialty mental health services. Services would be available 24 hours a day, seven days a week.

All contracts also include revised Conflicts of Interest language to align with updated countywide standard provisions. The contracts also include updated Program Modification Tool language to reflect the required utilization of an online BHSD Program Modification Tool by providers requesting changes to the caseloads, staffing, length of stay, dosages, and maximum financial obligations. All Program Modification Tool requests submitted are reviewed by BHSD leadership, the Finance Unit, and Contracts Administration through DocuSign. Each provider’s request is considered in correlation to respective contract performance, availability of funding, state and federal requirements, and the County’s needs.

The recommended actions support the County of Santa Clara Health System’s Strategic Road Map as it relates to the Triple Aim Plus Objectives by delivering coordinated and integrated personalized care to improve patient access and reduce utilization of emergency and acute services.

CHILD IMPACT

The recommended actions would have a positive impact on children and youth by providing sufficient and appropriate behavioral health services for this target population.

SENIOR IMPACT

The recommended actions would have a positive impact on seniors by providing sufficient and appropriate behavioral health services for this target population.

SUSTAINABILITY IMPLICATIONS

The recommended actions balance public policy and program interests and enhance the Board of Supervisors’ sustainability goal of social equity and safety by providing crucial behavioral health services and interventions to residents in Santa Clara County.

BACKGROUND

The BHSD is Santa Clara County’s Mental Health Plan (MHP) administrator and is required to provide or arrange behavioral health services for Medi-Cal beneficiaries. Under State and Federal regulations, each county’s MHP must ensure sufficient network adequacy to serve clients across the system and comply with the Federal Network Adequacy and Timely Access Standards. Santa Clara County’s MHP contract services are contained in two types of services: SD Medi-Cal and MHSA.  Services are provided to children, youth, adults, and older adults with SEDs and/or SMIs from all ethnic and cultural populations represented in Santa Clara County.

On November 2, 2004, California voters passed Proposition 63, also known as the MHSA, establishing new tax revenues to be used to expand County mental health service to children, adults, and seniors with severe mental illness and to fund prevention and early intervention services innovative programs, human resource development, and capital facilities and technology improvements.

The former State Department of Mental Health, now the Department of Health Care Services,  established the following five MHSA components: Community Services and Supports (CSS), which expands services to children with emotional disorders and seriously mentally ill transition age youth, adults, and seniors; Prevention and Early Intervention (PEI), which provides early intervention and prevention services; Workforce Education and Training (WET), which provides funds for consumer, family and staff training and workforce development; Capital Facilities and Technological Needs (CFTN), which provides funding for facilities and technology; and Innovation (INN), which funds innovative projects and programs to test new models of service delivery or system improvements.

CONSEQUENCES OF NEGATIVE ACTION

Failure to approve the recommended actions would result in the lack of available Medi-Cal services to meet client needs and support State and Federal network adequacy in FY 20-21.

STEPS FOLLOWING APPROVAL

Priority processing is requested for these Amendments. Upon approval, the Clerk of the Board is requested to send e-mail notifications to Evonne Lai (Evonne.Lai@hhs.sccgov.org), Angeleah Macatiag (Angeleah.Macatiag@hhs.sccgov.org), Ann Shaw (Ann.Shaw@hhs.sccgov.org), Tony Acosta (Tony.Acosta@hhs.sccgov.org), and Abigaile Tabilangan (Abigaile.Tabilangan@hhs.sccgov.org).

 

 

Meeting History

Jun 23, 2020 9:30 AM Video Board of Supervisors Regular Meeting

Removed from the Consent Calendar at the request of President Chavez.

Approved as amended to remove from the Fourth Amendment to Agreement with Seneca Family of Agencies the scopes of work relating to Enhanced Intensive Treatment Foster Care, Immediate Stabilization Services, Intensive Treatment Foster Care, Transitional Foster Care, and The Welcoming Center Services; and, hold those items to July 21, 2020.

RESULT:APPROVED AS AMENDED [UNANIMOUS]
MOVER:Cindy Chavez, President
SECONDER:Dave Cortese, Supervisor
AYES:Mike Wasserman, Cindy Chavez, Dave Cortese, Susan Ellenberg, S. Joseph Simitian