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Agenda Item
ASR
Control 25-000684 |
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MEETING
DATE: |
04/14/26 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
All
Districts |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Veronica
Kelley (714) 834-7024 |
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Ian
Kemmer (714) 834-2160 |
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Subject: Renewal of Contracts for Children
and Youth Outpatient Services
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ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: N/A |
Current Year
Cost: N/A |
Annual Cost: FY 2026-27 $62,830,000 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 4/25/2023 #16 |
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RECOMMENDED
ACTION(S):
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1. |
Approve
Amendment No. 2 to renew the contract with Child Guidance Center, Inc., for
provision of Children and Youth Outpatient Services for the term of July 1,
2026, through June 30, 2028, for an amount not to exceed $31,800,000, for a
revised total amount not to exceed $73,398,711. |
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2. |
Approve
Amendment No. 3 to renew the contract with Pathways Community Services LLC
dba Clarvida for provision of Children and Youth Outpatient Services for the
term of July 1, 2026, through June 30, 2028, for an amount not to exceed
$22,750,000, for a revised total amount not to exceed $56,862,424. |
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3. |
Approve
Amendment No. 3 to renew the contract with Seneca Family of Agencies for
provision of Children and Youth Outpatient Services for the term of July 1,
2026, through June 30, 2028, for an amount not to exceed $13,810,000, for a
revised total amount not to exceed $34,815,247. |
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4. |
Approve
Amendment No. 2 to renew the contract with Western Youth Services for
provision of Children and Youth Outpatient Services for the term of July 1,
2026, through June 30, 2028, for an amount not to exceed $57,300,000, for a
revised total amount not to exceed $143,243,961. |
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5. |
Authorize the
County Procurement Officer or Deputized designee to execute the Amendments
with Child Guidance Center, Inc., Pathways Community Services LLC dba
Clarvida, Seneca Family of Agencies and Western Youth Services, as referenced
in the Recommended Actions above. |
SUMMARY:
Approval of the amendments to renew
the contracts for provision of Children and Youth Outpatient Services will
support children and youth with serious emotional and behavioral health needs
through outpatient and community-based care.
BACKGROUND
INFORMATION:
On April 25, 2023, your Honorable
Board of Supervisors (Board) approved individual Contracts with Child Guidance
Center, Inc. (CGC), Pathways Community Services LLC dba Clarvida (Clarvida),
Seneca Family of Agencies (Seneca), and Western Youth Services (WYS) for the
delivery of Children and Youth Outpatient Services (CYOS). Approval of the
individual Amendments will provide for the continued delivery of Children and
Youth Outpatient Services for the renewal term of July 1, 2026, through June
30, 2028. Prior to the contract expiration, the Health Care Agency (HCA) plans
to conduct a solicitation to continue services.
These amendments ensure continuity
of care and maintain access to medically necessary behavioral health services
for children, youth, and families across Orange County (County). The Orange
County Preference Policy is not applicable to these amendments. All related
prior actions are included in the table below:
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Board
Date |
Contract |
Action |
Term |
Contract
Amount |
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4/23/2023 |
Contracts |
Board
approved contracts
with CGC, Clarvida, Seneca, and WYS |
July 1, 2023 -
June 30, 2026 |
CGC- $41,598,711 Clarvida -
$34,112,424 Seneca -
$20,708,247 WYS -
$85,943,961 |
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N/A |
CGC Amendment
No. 1 |
Deputy
Purchasing Agent
(DPA) Delegated
Authority Administrative
Revisions to Exhibit A and the Contract |
July 1, 2025 -
June 30, 2026 |
N/A |
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N/A |
Clarvida Amendment
No. 1 and Amendment No. 2 |
DPA
Delegated
Authority Administrative
Revisions to Exhibit A |
July 1, 2024 -
June 30, 2025 |
N/A |
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N/A |
Seneca
Amendment No. 1 and Amendment No. 2 |
DPA
Delegated Authority
Administrative Revisions to Exhibit A and the Contract |
July 1, 2024 -
June 30, 2025 |
N/A |
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N/A |
WYS
Amendment No. 1 |
DPA
Delegated Authority Administrative
Revisions to Exhibit A and the Contract |
July 1, 2025 -
June 30, 2026 |
N/A |
Scope of Services
Providers deliver medically
necessary behavioral health services to Medi-Cal eligible children and youth
under 21 years of age who have significant emotional or behavioral health
needs. Services are provided through a network of outpatient clinics and, when
clinically appropriate, in home, school, and community settings throughout
Orange County.
Services include individual, group,
and family therapy; behavioral health assessment and evaluation; medication
support; crisis intervention; case management; Therapeutic Behavioral Services;
Intensive Care Coordination; and Intensive Home-Based Services. These services
are designed to reduce symptoms, strengthen family functioning, and support
youth in achieving stability and improved functioning.
CYOS is a core component of the
County’s Medi-Cal Specialty Mental Health Services system for children and
youth under 21 years of age. CYOS play a critical role in the County’s
behavioral health continuum by providing early intervention, ongoing treatment,
and coordination with other County and community systems by delivering services
in accessible community-based settings. The program helps prevent unnecessary
escalation to higher levels of care and supports youth and families in
maintaining stability within their homes and communities. As the County
Behavioral Health Plan, County of Orange is required under State and federal
Medi-Cal requirements to ensure timely access to medically necessary behavioral
health services for eligible children and youtH. Providers are required to
follow Medi-Cal regulations and bill their services to Medi-Cal in addition to
adhering to HCA standards for quality, cultural responsiveness, and family
engagement.
Table
1:
Service Regions/Cities
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Region |
Cities
Served |
Providers |
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North |
Anaheim, Buena Park, Fullerton, La
Habra, La Palma, Placentia, Yorba Linda |
CGC, Clarvida, Seneca, WYS |
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Central |
Costa Mesa, Irvine, Newport Beach |
Clarvida (2 Locations) |
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East |
Orange, Santa Ana, Tustin, Villa Park |
CGC, Seneca, WYS (2 Locations) |
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West |
Cypress, Fountain Valley, Garden Grove,
Huntington Beach, Los Alamitos, Rossmoor, Seal Beach, Stanton, Westminster |
Clarvida, WYS |
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South |
Aliso Viejo, Dana Point, Laguna Beach,
Laguna Hills, Laguna Niguel, Laguna Woods, Lake Forest, Mission Viejo, Rancho
Santa Margarita, San Clemente, San Juan Capistrano |
CGC, Seneca, WYS |
Performance
Outcomes
CYOS providers use the Child and
Adolescent Needs and Strengths (CANS) assessment, a State-required tool that
helps identify each youth’s clinical needs, treatment priorities, and
strengths, particularly for those with complex needs or involvement in multiple
systems of care. CANS data are used to monitor progress during treatment and to
evaluate overall program effectiveness.
Over the past two Fiscal Years
(FY), CANS results indicate that providers have consistently achieved positive
outcomes across key clinical areas. A strong majority of youth receiving
outpatient services maintained or improved emotional well-being and behavior
regulation during treatment. Follow-up data also shows that nearly all youth
demonstrated low suicide risk, reflecting the effectiveness of safety planning,
crisis intervention, and ongoing clinical support.
In addition, providers
appropriately identified youth experiencing early signs of psychosis and
successfully referred them to specialized treatment programs when clinically
indicated, supporting early intervention and improved long-term outcomes. These
results demonstrated sustained clinical effectiveness across all contracted
providers while serving youth with significant and increasingly complex
behavioral health needs.
Table 2: Number of
Unduplicated Clients Served
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Provider |
FY 2023-24 # of unduplicated clients served |
FY 2024-25 # of unduplicated clients served |
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Western Youth
Services |
4255 |
4712 |
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Child Guidance
Center |
2165 |
2433 |
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Clarvida |
1589 |
1524 |
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Seneca |
891 |
850 |
Table 3: Clinical
Outcomes
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%
Youth Maintaining or Improving Clinical Outcomes During Treatment |
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Symptom
Area |
Target
Range |
CGC |
Clarvida |
Seneca |
WYS |
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FY |
FY |
FY |
FY |
FY |
FY |
FY |
FY |
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Mood
Symptoms |
65-70% |
84% |
84% |
79% |
86% |
72% |
79% |
67% |
71% |
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Behavior
Regulation |
75-80% |
84% |
87% |
91% |
88% |
84% |
86% |
81% |
79% |
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Suicide
Risk |
90-95% |
99% |
97% |
94% |
97% |
95% |
96% |
97% |
95% |
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Psychosis |
95-99% |
99% |
99% |
97% |
100% |
100% |
99% |
99% |
99% |
HCA establishes performance targets
based on historical and current CANS data trends across all outpatient
providers. Performance targets were increased after recent evaluation of data
trends to ensure they remain appropriate and clinically meaningful.
The contracts do not include
subcontractors. See Attachment E for the Contract Summary Forms.
The Contractors’ performances have been
confirmed as satisfactory. HCA has verified there are no concerns that must be
addressed with respect to Contractors’ ownerships/names, litigation status or
conflicts with County interests.
HCA requests the Board approve the
amendments with CGC, Clarvida, Seneca and WYS for provision of Children and
Youth Outpatient Services, as referenced in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for these Amendments
will be included in Budget Control 042 FY 2026-27 and in the budgeting process
for future years.
Funding
Sources:
State: 13% (Mental Health
Realignment and Behavioral Health Services Act)
Other: 87% (Federal Financial
Participation Medi-Cal)
The Contracts include provisions
allowing HCA to terminate the Contracts, reduce the level of services, and/or
renegotiate the levels of services provided, as necessary. This includes a
notice that allows HCA adequate time to transition or terminate services to
clients, if necessary.
STAFFING
IMPACT:
An analysis was completed to verify
the contract provides County with persons specially trained, experienced,
expert and competent to perform the special services in accordance with the
law.
ATTACHMENT(S):
Attachment
A – Amendment No. 2 to MA-042-23010952 for Children and Youth Outpatient
Services with Child Guidance Center, Inc.
Attachment B - Amendment No. 3 to Contract MA-042-23010955 for Children and
Youth Outpatient Services with Pathways Community Services LLC dba Clarvida
Attachment C – Amendment No. 3 to Contract MA-042-23010956 for Children and
Youth Outpatient Services with Seneca Family of Agencies
Attachment D – Amendment No. 2 to Contract MA-042-23010959 for Children and
Youth Outpatient Services with Western Youth Services
Attachment E - Contract Summary Forms for Attachments A-D