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Agenda Item
ASR
Control 24-000522 |
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MEETING
DATE: |
05/06/25 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
2 |
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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: Approve Contract for Patients
Rights' Advocacy and Advocate 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 2025-26 $1,570,373 |
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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: N/A |
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RECOMMENDED
ACTION(S):
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1. |
Approve Contract with Mental Health
Systems, Inc. for provision of Behavioral Health Patients Rights' Advocacy
and Certification Review Hearing for Patient Advocate Services, for the term
of July 1, 2025, through June 30, 2028, in an amount not to exceed $4,711,119,
renewable for one additional two-year term. |
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2. |
Pursuant to Contract Policy Manual
Section 3.3-113, authorize the County Procurement Officer or Deputized
designee to exercise a contingency contract cost increase in an amount not to
exceed a total of 10 percent of the contract amount for the first year of the
contract, for the entire term of the Contract, including renewals, and within
the scope of work set forth in the contract. The use of this contingency
contract cost increase is subject to approval requirements established by the
County Procurement Officer. |
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3. |
Authorize the Health Care Agency
Director or designee to designate Mental Health Systems, Inc., as the County
Patients Rights' Advocate with the duties and responsibilities as stated in
the Welfare and Institutions Code, Section 5150, 5250, 5256 and 5270.15. |
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4. |
Authorize the County Procurement Officer
or Deputized designee to execute Contract with Mental Health Systems, Inc. as
referenced in the Recommended Actions above. |
SUMMARY:
Approval of the Contract with
Mental Health Systems, Inc. for Behavioral Health Patients Rights' Advocacy and
Certification Review Hearing for Patient Advocates Services will provide
Advocacy services focused on the protection of the rights of persons with
behavioral health disorders.
BACKGROUND
INFORMATION:
The Health Care Agency (HCA) is
requesting the Honorable Board of Supervisors (Board) approve the Contract with
Mental Health Systems, Inc. (MHS) for provision of Behavioral Health Patients
Rights' Advocacy and Certification Review Hearing for Patient Advocate
Services.
HCA released a Request for Proposal
(RFP) for Behavioral Health Patients’ Rights Advocacy and Certification Review
Hearing for Patient Advocate Services on December 20, 2024, in the online
bidding system to solicit proposals for the services. There were two responders
to the RFP. An evaluation panel evaluated the proposals and recommended award
of the contract to MHS.
Proposal
Evaluation Process
Standard evaluation panels of five
members, two county staff with subject matter expertise, and three public
members with subject matter expertise, were recruited to evaluate the proposals
received. Evaluation panel members independently rated the proposals using
established criteria and possible maximum points of 1000.
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Respondent |
Average Score |
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Mental Health Systems, Inc. |
846.33 |
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Orange County Association for Mental
Health dba Mental Health Association of Orange County |
836.33 |
HCA staff have conducted due diligence on
the Respondent. Below are the reference checks, which have been confirmed as
satisfactory.
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Respondent |
Reference
Check |
Reference
Check |
Reference
Check |
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Mental Health Systems, Inc |
Department of Mental Health Los Angeles
– Patients Rights’ Advocates (Hearings) |
San Bernardino Patients Rights’ Advocacy
– provide services to clients in County LPS and Non-LPS facilities |
Disability Rights California – Civil
Rights Practice Group |
California has a legislatively
mandated patients rights' advocacy system made up of three components:
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1) |
County Patients
Rights' Advocates |
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2) |
State Hospital
Patients Rights' Advocates |
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3) |
The California
Office of Patients Rights'. Each county mental health director is required to
designate, or contract for the services of, Patients’ Rights Advocates
(Welfare and Institutions Code (WIC) Section 5520). |
Additionally, all patients placed
on a WIC 5250 or WIC 5270.15 hold have the right to a Certification Review
Hearing within four days of being placed on the involuntary hold. The patient
shall be represented by a Hearing Advocate during the hearing proceeding.
Orange County has 17 Lanterman
Petris Short (LPS) designated facilities including 3 Crisis Stabilization
Units, 1 Correctional Health inpatient unit, and 13 hospital facilities with
inpatient psychiatric units in which certification review hearings may be
conducted. Additionally, should a
patient be in an Emergency Department (ED) awaiting placement in an inpatient
psychiatric facility, and a WIC 5250 or 5256(b) is initiated a certification
review hearing must be conducted.
Scope
of Services
MHS will provide Patients Rights'
Advocacy Services in Orange County focused on the protection of the rights of
persons with behavioral health disorders. Additionally, upon Orange County’s
implementation of Senate Bill 43 on January 1, 2026, and the amended definition
of grave disability to include severe substance use disorder, Patients Rights'
Advocacy services will be inclusive of protecting the rights of persons with
both mental illness and severe substance use disorders.
Ensuring information about patients
rights' is posted in all facilities (this is inclusive of all inpatient
psychiatric facilities, mental health residential facilities, crisis
stabilization units, and outpatient clinics)
providing behavioral health services, and that all incoming clients and
recipients of behavioral health services in all licensed health and community
care facilities are informed of their rights, including the right to contact a
patients’ rights advocate and the California Office of Patients Rights', and
receive and investigate complaints from or concerning patients about violations
or abuse of their rights, and monitor behavioral health facilities, services
and programs for compliance with patients rights' laws, regulations and
policies, and train behavioral health providers about patients’ rights laws
regulations and policies and act as a consultant to staff in behavioral health
facilities in the area of patients rights', and advocate for patients and
residents who are unable or afraid to register a complaint, and act as a
liaison between the advocacy program and the California Office of Patients
Rights’.
Additionally, MHS will provide
advocacy services to patients during their certification review hearings in
compliance with WIC 5256 et seq. All patients detained in psychiatric hospitals
shall have a certification review hearing when a 14-day certification (5250) or
a 30-day certification (5270.15) has been filed. The certification review
hearing is to be held within 4 days of the patient being placed on the hold. A
facility representative must show probable cause that the person is a danger to
self, others, or gravely disabled due to a behavioral health disorder. The
facility representative must be a behavioral health professional designated by
the director of the facility. The Hearing Advocate represents the patient’s
wishes during the hearing. Prior to the Certification Review Hearing, the
Hearing Advocate will meet with the patient to assist the patient in preparing
for the hearing. A Certification Review Hearing Officer will preside over the
Certification Review Hearing and will make a determination, based off of
information presented, if there is due cause to continue the involuntary
treatment. If probable cause to continue involuntary treatment is substantiated,
the patient remains in the facility and in treatment. If no probable cause is
found, the patient may remain in the facility on a voluntary basis to continue
treatment or will be discharged.
MHS will work collaboratively with
the Behavioral Health Services, on all non-Medi-Cal member
complaints/grievances received from any behavioral health plan provider. MHS
will investigate the grievance/complaint and notify both the patient and the
provider of the outcome. An analysis was completed to determine the contracts
provide the County with persons specially trained, experienced, expert and
competent to perform the special services in accordance with the law.
Performance
Outcomes
MHS was the incumbent provider of
Patients Rights’ services. Outcomes two and three were previous performance
measures and were met. Outcomes one and four are new.
Patients
Rights’ Performance Outcomes
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1. |
Investigate 100 percent of non-Medi-Cal
member complaints/grievances according to the County Behavioral Health
Services Beneficiary and Client problem resolution policy and process. |
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2. |
Provide a minimum of two on-site visits
to the twenty-four hour (inpatient and residential facilities) per month. |
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3. |
Monitor all inpatient, 24-hour
residential facilities, correctional facilities, and outpatient programs for
adherence to procedure related to patients’ rights. |
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4. |
Submit to DHCS, on a quarterly basis, on
behalf of the MHP, Convulsive Treatments Administered report. This data point
is not captured via Senate Bill 929 data collection process that the
Behavioral Health Director submits quarterly to DHCS. |
Hearing
Advocate Performance Outcomes
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• |
Attend 100 percent of all certification
review hearings (5250, 5270.15, 5256 (b)). |
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• |
Provide hearing
advocacy services for Certification Review Hearings to persons receiving
inpatient psychiatric services and certified for involuntary, intensive
treatment pursuant to WIC section 5250, 5256(b), and 5270.15. |
HCA has verified there are no
concerns that must be addressed with respect to the Contractor’s
ownership/name, litigation status or conflicts with County interests.
The proposed Contract has a
subcontractor to provide legal consultation. See Attachment B for information
regarding subcontractor and Contract Summary Form.
HCA requests the Board approve the
selection of and Contract with MHS for provision of Behavioral Health Patients
Rights' Advocacy and Certification Review Hearing for Patient Advocate Services,
as referenced in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for this Contract
are included in Budget Control 042 FY 2025-26 Budget and will be included in
the budgeting process for future years.
Funding Sources:
GF: 1%
Federal: 4% (Substance Abuse
Prevention and Treatment Block Grant; Mental Health Block Grant).
State: 68% (Mental Health Services
Act/Prop 63; Mental Health Realignment; Tobacco Settlement Revenue)
Fees/Licenses/Other: 27%
The proposed contract is contingent
upon funding availability. In the event funding is reduced or terminated, the
County may renegotiate the level of services and/or terminate the contract, as
necessary.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A - Contract MA-042-25010810 for Provision of Behavioral Health Patients'
Rights Advocacy and Patient Advocate Services
Attachment B - Contract Summary Form
Attachment C - Scoring Sheets
Attachment D - Welfare and Institutions Code, Sections 5150, 5250, 5256,
5270.15, 5520-5523