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Agenda Item
ASR
Control 24-000538 |
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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): |
1,
2, 4, 5 |
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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 for Adult and Older Adult
Full Service Partnership 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 $30,909,157 |
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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: 5/24/2022 #26 |
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RECOMMENDED
ACTION(S):
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1. |
Approve Amendment No. 3 to renew the
Contract with Telecare Corporation, for provision of General Population Full
Service Partnership Services Region A, for the term of July 1, 2025, through
June 30, 2026, for an amount not to exceed $6,417,599, for a revised
cumulative contract total amount not to exceed $25,765,874. |
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2. |
Approve Amendment No. 3 to renew the
Contract with Telecare Corporation, for provision of General Population Full
Service Partnership Services Region B, for the term of July 1, 2025, through
June 30, 2026, for an amount not to exceed $3,938,615, for a revised
cumulative contract total amount not to exceed $14,737,410. |
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3. |
Approve Amendment No. 3 to renew the
Contract with Telecare Corporation, for provision of General Population Full
Service Partnership Services Region C, for the term of July 1, 2025, through
June 30, 2026, for an amount not to exceed $6,737,173, for a revised
cumulative contract total amount not to exceed $26,592,648. |
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4. |
Approve Amendment No. 2 to renew the
Contract with Telecare Corporation, for provision of Collaborative Court Full
Service Partnership Services, for the term of July 1, 2025, through June 30,
2026, for an amount not to exceed $3,447,656, for a revised cumulative
contract total amount not to exceed $16,581,776. |
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5. |
Approve Amendment No. 4 to renew the
Contract with College Community Services dba Clarvida for provision of
Criminal Justice Full Service Partnership Services for the term of July 1,
2025, through June 30, 2026, for an amount not to exceed $4,827,531, for a
revised cumulative contract total amount not to exceed $19,310,124. |
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6. |
Approve Amendment No. 2 to renew the
Contract with College Community Services dba Clarvida, for provision of Older
Adult Full Service Partnership Services, for the term of July 1, 2025,
through June 30, 2026, for an amount not to exceed $5,540,583, for a revised
cumulative contract total amount not to exceed $22,162,332. |
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7. |
Authorize the County Procurement Officer
or Deputized designee to execute the Amendments with Telecare Corporation and
College Community Services dba Clarvida, as referenced in the Recommended
Actions above. |
SUMMARY:
Approval of Amendments to renew the
Contracts with Telecare Corporation and College Community Services dba Clarvida
for provisions of Full Service Partnership Services will continue the provision
of mental health and supportive services to adults and older adults who have a
serious mental illness and/or co-occurring disorder.
BACKGROUND
INFORMATION:
The Health Care Agency (HCA) is
requesting your Honorable Board of Supervisors’ (Board) approval of the
Amendments with Telecare Corporation (Telecare) and College Community Services
dba Clarvida (CCS). Telecare and CCS have been collaborative partners in
successfully developing and operating the Adult and Older Adult Full Service Partnership
Services (FSP) programs and meeting the needs of the community.
On May 24, 2022, the Board approved
the Adult and Older Adult FSP Contracts with Telecare and CCS for the term July
1, 2022, through June 30, 2025. The below table details the prior Board actions
and Amendments to the Contracts that were executed under Deputy Purchasing
Agent (DPA) delegated authority.
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Board
Date |
Contract |
Action |
Term |
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May 24, 2022 |
General Population FSP
Regions A, B, C Collaborative Court FSP Criminal Justice FSP Older Adult FSP |
Board Approved Contract
Award for $19,348,275 (General Population FSP Region A), $10,615,470 (General
Population FSP Region B), $20,038,800 (General Population FSP Region C),
$13,134,120 (Collaborative Court FSP), $14,482,593 (Criminal Justice FSP) and
$16,621,749 (Older Adult FSP) |
July 1, 2022 – June 30,
2025 |
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N/A |
Amendment No. 1 & 2
to Criminal Justice FSP Contract |
DPA Delegated Authority
– Administrative Revisions |
February 16, 2023 –
June 30, 2025 |
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N/A |
Amendment No. 1 to
General Population FSP Regions A, B, C Contracts |
DPA Delegated Authority
– Administrative Revisions |
January 8, 2024 – June
30, 2025 |
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N/A |
Amendment No. 2 to
General Population FSP Regions A, B, C Contracts |
DPA Delegated Authority
– Administrative Revisions |
April 2, 2025 – June
30, 2025 |
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N/A |
Amendment No. 1 to
Collaborative Court FSP Contract |
DPA Delegated Authority
– Administrative Revisions |
July 1, 2024 – June 30,
2025 |
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N/A |
Amendment No. 1 to
Older Adult FSP and Amendment No. 3 to Criminal Justice FSP Contracts |
DPA Delegated Authority
– Administrative Revisions |
January 27, 2025 – June
30, 2025 |
Scope
of Services
FSP programs provide intensive
outpatient services and case management for individuals (adults ages 18 and
older) living with serious behavioral health conditions. The FSP framework is
based on a “no fail” philosophy and does “whatever it takes” to meet the needs
of clients, and when appropriate their families, including providing supportive
services. This framework builds strong connections to community resources and
provides field-based treatment and recovery services including crisis response
24 hours per day, 7 days per week. The primary goal of FSP programs is to
improve quality of life by implementing practices which consistently promote
good outcomes for the client. These outcomes include increasing safe and
permanent housing, reducing criminal or justice-involvement, and reducing high
frequency use of psychiatric hospitalizations or emergency and crisis services.
FSP programs strive to provide stabilizing services for the client at the
lowest level of care allowing for maximum flexibility to support wellness,
resilience and recovery.
The agreed upon
Scope of Works and Services outlined in the recommended Amendments for General
Population FSP Services Region A, Region B, and Region C, Collaborative Court
FSP Services, Criminal Justice FSP Services and Older Adult FSP Services are in
alignment with the Outreach and Supportive Services and Shelter Pillars' best
practices, guiding principles and commitments as detailed in the Homeless
Service System Pillar Report.
The FSP programs operate in accordance with
the County of Orange’s Standards of Care for Emergency Shelter Providers, a
comprehensive set of administrative, operational, and facility-based standards
designed to support the quality and consistency of emergency shelter program
operations, evidence-based participant services, core organizational/
administrative functions, and facility design/operations.
The ages served, average daily
volume to be served, location and referral sources for the six service areas
are as follows:
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FSP |
Ages Served |
Average Daily Volume To Be Served |
Location |
Primary Referral Source |
|
General
Population- Region
A (North) Region
B (South) Region
C (Central) |
18-59
years old |
273
clients 127
clients 230
clients |
Anaheim Costa
Mesa Garden
Grove |
Community
including family, County of Orange (County) Behavioral Health clinics and
Open Access |
|
Collaborative
Court |
18
years old and older |
80
clients |
Santa
Ana |
Public
Defender, Collaborative Court |
|
Criminal
Justice |
18
years old and older |
197
clients |
Anaheim |
Probation,
Correctional Health Services |
|
Older
Adult |
60
years old and older |
215
clients |
Orange |
Community
including family, County Behavioral Health clinics and Open Access |
Performance
Outcomes
FSP providers use state-mandated data
fields to evaluate the effectiveness of the model in supporting the wellness,
recovery and safety of its FSP clients. FSP program targets, newly established
in 2022, specify at least 80 percent of FSP clients served will:
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• |
Remain safely in the community and not
require psychiatric hospitalization |
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• |
Not be arrested for a new legal charge |
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• |
Remain out of custody |
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• |
Remain in shelter/housing (e.g., not
experience unsheltered homelessness) |
The goal of 80 percent was determined by
taking into account past and current data trends across all FSP programs. The
80 percent benchmarks may be refined as additional years of data are analyzed,
with particular attention paid to whether separate indicator benchmarks should
be established for programs based on areas of specialization (i.e., age groups,
justice involved, etc.). Outcomes for Fiscal
Years (FYs) 2022-23 and 2023-24 are listed in the tables below.
|
FY
2022-23 FSP
& Clients Served |
Did
Not Require Psychiatric Hospitalization Goal = 80% |
Was
Not Arrested for New Legal Charge Goal = 80% |
Remained
Out of Custody Goal = 80% |
Did
Not Experience Unsheltered Homelessness Goal = 80% |
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# Clients |
% |
# Clients |
% |
# Clients |
% |
# Clients |
% |
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General
Population-Region A* 290
clients served |
248 |
87.3% |
248 |
87.3% |
240 |
84.5% |
224 |
78.9% |
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General
Population-Region B 163
clients served |
129 |
79.1% |
148 |
90.8% |
140 |
85.9% |
126 |
77.3% |
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General
Population-Region C* 342
clients served |
312 |
91.8% |
324 |
95.2% |
304 |
89.4% |
222 |
65.2% |
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Criminal
Justice* 212
clients served |
155 |
95.1% |
154 |
94.5% |
134 |
82.2% |
113 |
69.3% |
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Collaborative
Court* 127
clients served |
121 |
96.0% |
125 |
99.2% |
63 |
50.0% |
126 |
100% |
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Older
Adult* 245
clients served |
203 |
92.3% |
219 |
99.6% |
211 |
95.9% |
175 |
79.6% |
|
FY
2023-24 FSP
& Clients Served |
Did
Not Require Psychiatric Hospitalization Goal = 80% |
Was
Not Arrested for New Legal Charge Goal = 80% |
Remained
Out of Custody Goal = 80% |
Did
Not Experience Unsheltered Homelessness Goal = 80% |
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# Clients |
% |
# Clients |
% |
# Clients |
% |
# Clients |
% |
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General
Population-Region A* 441
clients served |
376 |
86.4% |
377 |
86.7% |
365 |
83.9% |
293 |
67.4% |
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General
Population-Region B* 216
clients served |
160 |
75.5% |
188 |
88.7% |
186 |
87.7% |
162 |
76.4% |
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General
Population-Region C* 322
clients served |
271 |
85.5% |
296 |
93.4% |
293 |
92.4% |
217 |
68.5% |
|
Criminal
Justice* 196
clients served |
179 |
100% |
176 |
98.3% |
167 |
93.3% |
165 |
92.2% |
|
Collaborative
Court 125
clients served |
118 |
94.4% |
119 |
95.2% |
72 |
57.6% |
125 |
100% |
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Older
Adult 278
clients served |
276 |
99.3% |
277 |
99.6% |
278 |
100% |
246 |
88.5% |
*Program
percentage based on data available for analysis. For FY 2022-23, analysis
completed for 284 clients for General Population-Region A, 340 clients for
General Population-Region C, 163 clients for Criminal Justice, 126 clients for
Collaborative Courts,
and 220 clients for Older Adult FSP. For
FY 2023-24, analysis completed for 435 clients for General Population-Region A,
212 clients for General Population-Region B, 317 clients for General
Population-Region C, and 179 clients for Criminal Justice FSP.
FSP programs met most of their targets and
helped the majority of clients served sustain recovery while receiving
services. For Collaborative Court FSP for FY 2022-23 and FY 2023-24, the
percentage “Remained out of Custody” is 50 percent and 57.6 percent
respectively. As a consequence of violating program rules, clients were subject
to brief, short term sanction (disciplinary detention) typically lasting
between one to three nights. For FY 2023-24 General Population Region B FSP had
more clients with significant co-occurring issues that impacted their
psychiatric hospitalization percentage. Limited housing resources and clients’
behaviors affected the General Population FSPs percentages for “Did Not
Experience Unsheltered Homelessness”. The FSP programs are working closely with
HCA Housing and Supportive Services and housing vendors to increase housing
resources and supporting clients to address behaviors so they can remain
housed.
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. The Orange County Preference Policy is not
applicable to these amendments.
HCA has worked to incorporate the Homeless
Service System Pillars Attestations into the Amendments for the renewal of the
Contracts for General Population FSP Services Region A, Region B, and Region C,
Collaborative Court FSP Services, Criminal Justice FSP Services and Older Adult
FSP Services, for the Outreach and Supportive Services and Shelter Pillars as
applicable to the FSP services being provided.
The proposed Amendments with Telecare for
provision of General Population FSP Services Region A, Region B, Region C and
Collaborative Court FSP Services and with CCS for provision of Criminal Justice
and Older Adult FSP Services will have subcontractors. See Attachment G for
information regarding subcontractors and Contract Summary Forms.
HCA requests that the Board approve the
Amendments with Telecare for provision of General Population FSP Services
Region A, B and C; Telecare for provision of Collaborative Court FSP Services;
CCS for provision of Criminal Justice FSP Services; and CCS for provision of
Older Adult FSP Services, as referenced in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for these Contracts
will be included in Budget Control 042 FY 2025-26 Budget.
Funding
Source:
State: 15% (Mental Health Services
Act/Prop 63 and State General Fund)
Fees/Other: 85% (Medi-Cal Federal
Financial Participation)
The proposed contracts include provisions
allowing HCA to terminate the Contract, 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:
N/A
REVIEWING
AGENCIES:
Office
of Care Coordination
ATTACHMENT(S):
Attachment
A - Amendment No. 3 to Contract MA-042-22011470 for General Population Full
Service Partnership Services Region A with Telecare Corporation
Attachment B - Amendment No. 3 to Contract MA-042-22011473 for General
Population Full Service Partnership Services Region B with Telecare Corporation
Attachment C - Amendment No. 3 to
Contract MA-042-22011474 for General Population Full Service Partnership
Services Region C with Telecare Corporation
Attachment D - Amendment No. 2 to Contract MA-042-22011475 for Collaborative
Court Full Service Partnership Services with Telecare Corporation
Attachment E - Amendment No. 4 to Contract MA-042-22011476 for Criminal Justice
Full Service Partnership Services with College Community Services dba Clarvida
Attachment F - Amendment No. 2 to
Contract MA-042-22011477 for Older Adult Full Service Partnership Services with
College Community Services dba Clarvida
Attachment G - Contract Summary Forms for Attachments A-F