Agenda Item   



                                                                                                                        ASR Control  19-001234




legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Annette Mugrditchian (714) 834-5026 



Jeffrey Nagel (714) 834-7024



Subject:  Behavioral Health System Transformation Innovation Project Part II


      ceo CONCUR

County Counsel Review

Clerk of the Board


Approved Agreement to Form




3 Votes Board Majority




    Budgeted: Yes

Current Year Cost: FY 2019-20 $2,173,333

Annual Cost: FY 2020-21 $5,526,667
FY 2021-22 $660,000




    Staffing Impact:


# of Positions:

Sole Source: No

    Current Fiscal Year Revenue: N/A

  Funding Source: 100% (Mental Health Services Act/Prop 63)

County Audit in last 3 years: No



    Prior Board Action: 10/08/2019 #9, 04/09/2019 #10






Approve Participation Agreement Number 510-ITS-DRN-2019 with the California Mental Health Services Authority for Behavioral Health System Transformation Innovation Project Part II for a total of $8,360,000 for the period of January 21, 2020, through June 30, 2022.



Authorize the Health Care Agency Director, or designee, to execute the Agreement in Recommended Action #1.



Direct the Auditor-Controller to distribute funds to the California Mental Health Services Authority upon the approval of the Participation Agreement referenced in Recommended Action #1.







Approval of the California Mental Health Services Authority Participation Agreement for Behavioral Health System Transformation Innovation Project Part II will create a comprehensive digital resource navigator tool and provide evaluation for the overall project.






Five percent of Mental Health Services Act (MHSA) funds are allocated to Innovation (INN) for the purpose of evaluating the effectiveness of new and/or changed approaches and practices in mental health to improve the mental health system of care. INN projects are designed and/or implemented for a defined time period and evaluated to develop new best practices in mental health services and supports.


On April 9, 2019, your Honorable Board of Supervisors (Board) approved the use of $18,000,000 in INN funds to plan for, develop and test a new public and private payment model that will create a quality-driven, culturally responsive behavioral health system. Subsequently, on October 8, 2019, the Board approved the use of $7,700,000 for the provision of Behavioral Health System Transformation INN project Part I through the development of performance/value-based contracts.


The Health Care Agency (HCA) is requesting approval to enter into a Participation Agreement (PA) with California Mental Health Services Authority (CalMHSA) for a total of $8,360,000 for the period of January 21, 2020, through June 30, 2022, to provide fiscal and administrative oversight for the development of a comprehensive and dynamic digital resource navigation tool and project evaluation. This project is related to efforts within the Help@Hand cross-county “Tech Suite” project, which also operates under a CalMHSA PA. The selection of and Agreement with CalMHSA for this project will allow HCA to leverage the subject matter expertise and digital resources available within the Help@Hand project, thereby creating administrative efficiencies in the execution of this project, as well as allow adaptability and expansion of the directory through the cross-county collaborative, which was a stated interest of the state Mental Health Services Oversight and Accountability Commission.


Navigating the behavioral health system continues to be a challenge. Individuals who are not familiar with behavioral health systems often are unable to identify needed services without support because available resource directories largely tend to be outdated as soon as they are published and/or are incomplete with regard to program listings or information. Effective system navigation is further complicated when individuals and/or their families are eligible for services that are offered outside of their insurance plan. The proposed digital resource navigation platform will give public and private providers direct access to update their program information online, as often as needed, so the directory remains current. An optional electronic social determinants survey will also be developed so that individuals who are unsure of how to begin a search can receive computer-assisted guidance towards resources that are filtered and prioritized based on their reported needs.


This project aims to assist individuals with navigating the public and private behavioral health systems of care in Orange County, and HCA will partner with local agencies and organizations to consolidate and integrate their disparate directories into a single source of information. The goal of the navigation tool is to reduce or prevent behavioral health crises, emergency department visits and/or avoidable involvement with the Criminal Justice system by helping consumers link to appropriate services and support. As such, this project is aligned with Pillars 1 (Prevention) and 4 (Re-Entry) of the Integrated Services 2025 Vision. In addition, the development of this digital resource navigation tool will complement the Crisis Response Network (CRN), which is currently in development in partnership with Mind OC. While the CRN provides an immediate response and intervention for individuals actively experiencing a behavioral health crisis, the digital resource navigation tool can be utilized by HCA providers to prevent future crises by linking consumers to ongoing care as they discharge from crisis services programs.


Finally, both parts of the Behavioral Health System Transformation project will be evaluated through focus groups, interviews, observational studies and surveys of stakeholders, subject matter experts and meeting participants.


Project Activities:

  • Outline the scope of directory, which will include the nature and types of services from the public, private and non-profit sectors that will be listed.
  • Identify the phases of roll out and the specific service types to be included in each phase.
  • Outline directory features, including real-time provider updates and consumer reviews.
  • Create an optional social determinants survey, developed in collaboration with stakeholder input, which will guide the user search and prioritize suggested resources based on their needs.
  • Build the digital resource directory.
  • Beta test and revise the directory and the social determinants survey.
  • Conduct a formative evaluation using focus groups, interview, observational studies and surveys.


CalMHSA Joint Powers of Authority

Through the Joint Powers of Authority, CalMHSA will act as the fiscal intermediary and contracting agent for the development of a digital resource navigator and project evaluation on behalf of the County. The CalMHSA PA contains a mutual indemnification provision that differs from the County’s standard sole indemnification practice and requires each party to indemnify, defend and hold harmless the other from and against any and all claims, losses, damages, liabilities, disallowances, recoupment and expenses, including, but not limited to, reasonable attorney’s fees, arising out of or resulting from other’s negligence in the performance of its obligations under the PA except to the extent the claims, etc., are the result of the negligence or willful misconduct of the party. CEO Risk Management has reviewed and approved the indemnification.


This Agenda Staff Report is being brought before the Board less than 30-days before the start of the contract term due to the urgency of moving the project forward, as this INN project will be implemented for a defined time-period of less than three years.


HCA requests that your Board approve the proposed PA with CalMHSA for Behavioral Health System Transformation Innovation Project Part II, as referenced in the Recommended Actions.






Appropriations and revenue for this Agreement are included in Budget Control 042 in FY 2019-20 and will be included in the budgeting process for future years.










Attachment A - California Mental Health Services Authority Participation Agreement
Attachment B - Risk Assessment Form