AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 20-000892
MEETING DATE:	04/27/21
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	1
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Annette Mugrditchian (714) 834-5026
	Jeff Nagel (714) 834-7024

Subject: Renewal Amendment No. 2 for Non-Emergency Transportation Services

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: N/A

Current Year Cost: N/A

Annual Cost: FY 2021-22 $1,500,000

Staffing Impact:

# of Positions:

Sole Source: No

Current Fiscal Year Revenue: N/A

Funding Source: FED: 17% (Substance Abuse Prevention and Treatment Block Grant), State: 83% (Mental Health Services Act/PROP 63, Mental Health CONREP)	County Audit in last 3 years: No

Prior Board Action: 03/24/2020 #29, 04/24/2018 #30

RECOMMENDED ACTION(S):

Approve Amendment No. 2 to renew the Contract with Cabco Yellow, Inc., dba California Yellow Cab for provision of Non-Emergency Transportation Services for the term July 1, 2021, through June 30, 2022, for an amount not to exceed $1,500,000, for a revised cumulative contract total amount of $5,500,000, renewable for one additional one-year term.

Authorize the County Procurement Officer or authorized Deputy to execute Amendment No. 2 to contract with Cabco Yellow, Inc., dba California Yellow Cab as referenced in the Recommended Action above.

SUMMARY:

Approval of Amendment No. 2 to renew the contract with Cabco Yellow, Inc., dba California Yellow Cab for provision of Non-Emergency Transportation Services will provide transportation assistance to adults in getting to their behavioral health and medical appointments, as well as to other supportive Behavioral Health Services that support their overall treatment goals.

BACKGROUND INFORMATION:

Your Honorable Board of Supervisors (Board) approved the Contract and Amendment for the provision of Non- Emergency Transportation Services with Cabco Yellow, Inc., dba California Yellow Cab (Yellow Cab).

Contract / Amendment

Board Date

Action

Term

Contract

April 24, 2018

Board Approved Contract

July 1, 2018 - June 30, 2021

Amendment No. 1

March 24, 2020

Board Approved Amendment to increase funding

July 1, 2018 - June 30, 2021

Scope of Services

The overarching goal of this program is to remove transportation barriers that affect clients from receiving necessary behavioral health and medical services. Non-Emergency Transportation Services are provided at no cost to seriously and persistently mentally ill Orange County adults, 18 years of age and older, including those with co-occurring substance abuse disorders, who require assistance getting to their scheduled behavioral health and medical appointments due to transportation barriers, as determined by their treatment provider. Clients eligible for transportation services may come from Adult and Older Adult Behavioral, Prevention and Intervention and Conditional Release programs. Clients who miss scheduled appointments are at greater risk of relapse and may end up incarcerated, increasing utilization of emergency departments in the County’s Crisis Stabilization Units or in long-term hospital inpatient stays because they did not receive necessary medication, behavioral health treatment or medical treatment critical to their stability and recovery. Clients who meet the eligibility criteria above are issued an authorization card and make their own appointments for transportation services with as little as 24-hour notice and up to 14 days in advance, using a toll-free telephone number established by Yellow Cab.

Yellow Cab has a substantial fleet of vehicles operating in Orange County, equipped and able to manage the volume of clients who may access the Transportation services, which is anticipated to be greater than 1,200 unique clients annually. The provider offers curb-to-curb services for all clients requesting transportation, and they will provide door-to-door services for those clients who may need extra assistance entering and exiting the vehicle from their residence or appointment location. Escorts for those individuals that may need additional support from a loved one or family member at their appointments may accompany clients at no additional cost. Additionally, service animals are allowed to accompany clients to their appointments at no additional cost, if required.

Since the implementation of the program, utilization of transportation services increased significantly, by more than 50 percent over the original anticipated service level. This increase is due to the frequency of behavioral health and, particularly, medical appointments for the target populations served by this program. Adults who have complicated medical issues may require multiple medical appointments on a monthly basis to treat their physical issues, resulting in higher utilization of the transportation services. Adults with substance use issues that have criminal justice involvement have more frequent utilization of this service due to court orders for drug testing multiple times weekly, attending Alcoholics Anonymous or Narcotics Anonymous groups on a frequent basis, court hearings and meetings with their Probation Officers.

Performance Outcomes

The established outcomes for the Non-Emergency Transportation Services program are: 1) On-time performance by arriving within a 30-minute timeframe from the scheduled pick-up or drop-off time; 2) Total trip time of less than 45 minutes to or from passenger destinations; and 3) Less than two missed pick-up or drop-off appointments per month. Actual performance outcomes for this program are identified in the table below:

Contracted Outcomes	FY 2019-20 Actual Outcomes	FY 2020-21 (July – January) Actual Outcomes

80% on-time performance (within 30 min)	79%	70%

80% total trip time < 45 minutes	93%	97%

80% less than two missed appointments per month	91%	96%

1,200 minimum unduplicated clients served	1,664	859

Total trips completed	36,714	12,687

On-time performance is based on 24-hour advance notification. The COVID-19 pandemic impacted in-person program services of all types in the County of Orange, as well as the utilization of Transportation services, and resulted in significant budget under expenditures. At this time, the utilization of Transportation services is anticipated to continue to be lower than expected into FY 2021-22.

Yellow Cab has subcontracts with its drivers who will carry out specific obligations of the Contract. The estimated annual amount of the subcontracts is $920,303. See Attachment B for information regarding subcontractors and Contract Summary Form.

The Contractor’s performance has been confirmed as above satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractor's ownership/name, litigation status or conflicts with County interests.

HCA requests the Board approve Amendment No. 2 to renew the Contract with Yellow Cab for provision of Non-Emergency Transportation Services as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this Contract will be included in Budget Control 042 FY 2021-22 Budget.

Should services need to be reduced or terminated due to lack of funding, the Contract contains language that allows the HCA to give a 30-day notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Amendment No. 2 to Contract MA-042-19010157 for Provision of Non-Emergency Transportation Services with Cabco Yellow, Inc., dba California Yellow Cab
Attachment B - Contract Summary Form
Attachment C - Redline Version of Attachment A