Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  24-000538

 

MEETING DATE:

05/06/25

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

1, 2, 4, 5

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Veronica Kelley (714) 834-7024 

 

 

Ian Kemmer (714) 834-2160

 

 

Subject:  Renewal for Adult and Older Adult Full Service Partnership 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 2025-26 $30,909,157

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:     See Financial Impact Section

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         5/24/2022 #26

 

RECOMMENDED ACTION(S):

 

 

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.

 

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.

 

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.

 

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.

 

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.

 

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.

 

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.


 

 

Board Date

Contract

Action

Term

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

N/A

Amendment No. 1 & 2 to Criminal Justice FSP Contract

DPA Delegated Authority – Administrative Revisions

February 16, 2023 – June 30, 2025

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

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

N/A

Amendment No. 1 to Collaborative Court FSP Contract

DPA Delegated Authority – Administrative Revisions

July 1, 2024 – June 30, 2025

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:

 

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:

 

Remain safely in the community and not require psychiatric hospitalization

Not be arrested for a new legal charge

Remain out of custody

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%

 

# Clients

%

# Clients

%

# Clients

%

# Clients

%

General Population-Region A*

290 clients served

248

87.3%

248

87.3%

240

84.5%

224

78.9%

General Population-Region B

163 clients served

129

79.1%

148

90.8%

140

85.9%

126

77.3%

General Population-Region C*

342 clients served

312

91.8%

324

95.2%

304

89.4%

222

65.2%

Criminal Justice*

212 clients served

155

95.1%

154

94.5%

134

82.2%

113

69.3%

Collaborative Court*

127 clients served

121

96.0%

125

99.2%

63

50.0%

126

100%

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%

 

# Clients

%

# Clients

%

# Clients

%

# Clients

%

General Population-Region A*

441 clients served

376

86.4%

377

86.7%

365

83.9%

293

67.4%

General Population-Region B*

216 clients served

160

75.5%

188

88.7%

186

87.7%

162

76.4%


 

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%

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