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Agenda Item
ASR
Control 24-000135 |
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MEETING
DATE: |
05/07/24 |
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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: |
County
Executive Office (Approved) |
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Department contact person(s): |
Douglas
Becht (714) 834-2323 |
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Amanda
Sanchez (714) 834-3268 |
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Subject: Renewal Contracts for Regional Care
Coordination 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 2024-25 $5,483,334 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: No |
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Current Fiscal Year Revenue: Yes
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Prior Board Action: 11/7/2023 #12, 9/13/2022 #15 |
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RECOMMENDED
ACTION(S):
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1. |
Approve
Amendment No. 4 and authorize the County Procurement Officer or Deputized
designee to renew and execute the Contract with Volunteers of America of Los
Angeles for Regional Care Coordination Services in the North Service Planning
Area, for a term effective from July 1, 2024, through June 30, 2026, for an
amount not to exceed $5,333,334, for a revised cumulative total amount not to
exceed $8,913,026. |
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2. |
Approve
Amendment No. 3 and authorize the County Procurement Officer or Deputized
designee to renew and execute the Contract with PATH, People Assisting the
Homeless for Regional Care Coordination Services in the Central Service
Planning Area, for a term effective from July 1, 2024, through June 30, 2026,
for an amount not to exceed $5,633,334, for a revised cumulative total amount
not to exceed $13,194,537. |
SUMMARY:
Approval of Amendments to renew the
Contracts for Regional Care Coordination Services will provide targeted
outreach services that help respond to and address the unsheltered homeless
conditions and provide comprehensive care coordination in the North and Central
Service Planning Areas.
BACKGROUND
INFORMATION:
Regional Care Coordination Services
help to engage and serve individuals experiencing unsheltered homelessness in
each Service Planning Area (SPA) and works to provide comprehensive care
coordination. Volunteers of America Los Angeles (VOALA) and PATH, People
Assisting the Homeless (PATH) work with the County of Orange (County), their
respective cities and local stakeholders to identify individuals experiencing
unsheltered homeless conditions in the community that would benefit from
disability application assistance and robust care coordination to address their
barriers to permanent housing and stability. Referrals for the Regional Care
Coordination Services are received from OC Health Care Agency (HCA) Outreach
and Engagement (O&E) for individuals experiencing homelessness that need
and qualify for comprehensive care coordination services. Care coordination
services provide comprehensive assistance to individuals experiencing
homelessness by linking them to the variety of resources designed to address
the complex needs of this population and adopt a "whatever it takes"
approach to reduce and eliminate barriers to service engagement and
participation. This care coordination is provided to the participant as they
navigate through the County's Systems of Care - Behavioral Health, Healthcare,
Housing, Community Corrections, and Benefits and Support Services - to access
appropriate services and through successful placement in permanent housing with
the appropriate supportive services to ensure sustainability.
Prior
Board Actions
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Board
Date |
Contract |
Action |
Term |
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September 13,
2022 |
Approve
Contracts with VOALA and PATH for Regional Care Coordination Services |
Approved as
Recommended |
October 15,
2022, through June 30, 2024 |
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November 7, 2023 |
Approve Contract
with Friendship Shelter, Inc. for Regional Care Coordination Services in
South SPA |
Approved as
Recommended |
December 15,
2023, through June 30, 2025 |
The proposed Amendments will renew
Regional Care Coordination Services for individuals experiencing homelessness
in the North and Central SPAs for two additional years, from July 1, 2024, to
June 30, 2026. During the renewal term, VOALA will provide Regional Care
Coordination Services in the North SPA and PATH will provide Regional Care
Coordination Services in the Central SPA only, as Friendship Shelter has been
contracted to provide Regional Care Coordination Services in the South SPA.
Scope of Services:
The Regional Care Coordination
Services are designed to provide comprehensive care coordination with the goal
of assisting individuals to increase their income and secure permanent housing.
The Regional Care Coordination Services includes the following service
elements:
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1. |
Coordinate with
O&E to determine areas for targeted outreach and engagement to build
relationships that provide care coordination and support in accessing
services, mainstream services, homeless service programs and other resources. |
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2. |
Intake and
assessment to determine the history of participation in other homeless
service programs and collection of needed or missing information. |
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3. |
Case management
services to ensure proper care coordination to address the needs of
participants with a focus on providing support and identifying permanent
housing options. |
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4. |
Disability
benefits advocacy to support participants in filing complete and timely
applications and appeals, represent individuals at administrative hearings
and establish good working relationships with the Social Security
Administration services providers as needed to ensure adequate representation
utilizing the SSI/SSDI Outreach, Access and Recovery (SOAR) model. |
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5. |
Housing
navigation services to support the participant in identifying available
housing units and resources, completing needed forms and applications for
housing. |
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6. |
Coordinate and
collaborate with the other components of the System of Care, Orange County
Continuum of Care and key stakeholders throughout the SPA to employ a
multidisciplinary approach to assist participants in accessing services
and/or programs. |
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7. |
Participate in
the Care Plus Program, the System of Care Data Integration System (SOCDIS)
and assist in the engagement of high utilizes of County services by gathering
consent and expeditiously connecting participants to the correct service or
resource cohesively by facilitating transportation. |
Additionally, PATH's scope of work
will continue to include care coordination services under the Encampment
Resolution Funding (ERF) Program to people experiencing homelessness within the
encampment located at Beach Boulevard and Trask Avenue in the City of Garden
Grove. PATH will transition the ERF Program team from the City of Costa Mesa
working to address the Talbert Regional Park to the City of Garden Grove
starting July 1, 2024. This will allow the County and the City to leverage the
experience and expertise in working with ERF and addressing homeless
encampments. This includes dedicated staffing to engage, build rapport and help
ensure connections to services and housing options. PATH will utilize the care
coordination model and employ a multidisciplinary approach for service
delivery. PATH will leverage regional collaboration between street outreach
providers, street medicine programs, and other community-based organizations to
provide personalized and comprehensive wrap-around services.
The agreed upon Scope of Works and
Services outlined in each provider's proposed Amendment are in alignment with
the Outreach and Supportive Services, Shelter and Housing Pillars' best
practices, guiding principles and commitments as detailed in the Homeless
Service System Pillar Report.
Performance
Metrics:
As part of the Renewal Contract,
VOALA will provide Regional Care Coordination Services to a minimum of 450
unduplicated participants in the North SPA during the two-year term. As part of
the Amendment, PATH will provide Regional Care Coordination services to a
minimum of 620 unduplicated participants in the Central SPA during the two-year
term of the Contract. PATH will also provide ERF Program Services to 60
unduplicated persons experiencing homelessness in the Beach Boulevard and Trask
Avenue Encampment in the City of Garden Grove during the term of the Contract.
The target goals for the
performance metrics are detailed below. Three performance metrics have been
revised from the original contract term and are noted below.
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1. |
At minimum, 80
percent of participants will have an Individualized Housing and Service Plan
within 30 calendar days of program enrollment. |
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2. |
At minimum, 90
percent of participants will be connected to the Coordinated Entry System
within 30 calendar days of program enrollment. |
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3. |
Of participants
who have a disability and are not receiving disability benefits, 50 percent
of participants will have submitted a disability benefit application or
appeal within 150 days of program enrollment. |
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4. |
Of the
disability benefit applications submitted, a minimum of 40 percent of
disability benefit applications will receive approval, inclusive of initial
applications, reconsideration requests and/or appeals and hearing processes. |
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5. |
At minimum, 50
percent of participants will enroll into an emergency shelter or temporary
housing destination while enrolled in the program. |
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6. |
At minimum, 30
percent of participants will transition to a permanent housing destination. |
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7. |
At minimum, 50
percent of participants who move into permanent housing destinations will do
so within 120 days of enrollment to the program. |
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8. |
At minimum, 50
percent of participants will have a higher income at program exit than at
program entry due to employment and/or mainstream benefits. |
From October 15, 2022, to January
31, 2024, the following performance outcomes were achieved:
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Performance Metrics |
VOALA |
PATH |
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Number of
households enrolled in the program |
259 |
401 |
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80 Percent of
households that established an Individualized Housing and Service Plan within
30 days of program enrollment |
90% |
68% |
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90 Percent of
households connected to CES within 30 days of program enrollment |
69% |
67% |
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Number
of disability applications or appeals submitted |
64 |
72 |
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50 Percent of
participants who have a disability and were assisted with submitting an
application or appeal for the first time within 120 days of program
enrollment |
26% |
28% |
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40 Percent of
approved disability benefit applications submitted |
30% |
23% |
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50 Percent of
participants enrolled into an emergency shelter or temporary housing
destination while enrolled in the program |
41% |
32% |
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50 Percent of
participants who transitioned to a permanent housing destination |
16% |
12% |
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50 Percent of
participants who moved into permanent housing destinations within 120 days of
enrollment to the program |
60% |
63% |
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Number of
households exited from the program |
121 |
119 |
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50 Percent of
participants with increased income at program exit |
9% |
9% |
VOALA and PATH are currently low
performing on one or more of the outlined performance outcomes. Noting that
this was a new program model and just completed its first-year operations, the
Office of Care Coordination reviewed the performance metrics from the original
contract against the current performance of VOALA and PATH. The Office of Care
Coordination has determined that three performance metrics should be reduced
due to better understanding of our system and how to better reflect the
contracted service providers’ ability to provide the required services at an
appropriate level. The process of applying for disability benefits is lengthy
and daunting, and many participants require longer than 120 days to complete
the necessary steps to submit a complete application or appeal, including
obtaining documentation and connecting with a primary care physician. The
performance metric associated with the percent of participants who submit a
disability benefits application or appeal has been reduced from 90 percent to
50 percent and the timeframe for submissions has increased from 120 days to 150
days. Additionally, in the first year of services, less participants than
anticipated have transitioned to a permanent housing destination and the
associated performance metric has been reduced from 50 percent to 30 percent.
The Office of Care Coordination recognized that there has been impacts to the
available housing resources and challenges in the rental market that have
impacted programs across the homeless service system. The Office of Care
Coordination continues to actively work with VOALA and PATH to review practices
related to the program operations and implement strategies that will assist in
improving performance outcomes. The Office of Care Coordination continues to
monitor performance outcomes closely.
The Contractors’ performances have
been confirmed as satisfactory. The County Procurement Office has verified
there are no concerns that must be addressed with respect to Contractors’
ownerships/names, litigation status or conflicts with County interests.
These Contracts do not currently
include subcontractors or pass through to other providers. See Attachments E
and F for the Contract Summary Forms. The Orange County Preference Policy is
not applicable to this Contract award. The Office of Care Coordination has
worked to incorporate the Homeless Service System Pillars Attestations into the
Amendment for the renewal of Contracts as detailed in the recommended actions,
for the Outreach and Supportive Services, Shelter and Housing Pillars as
applicable to the Regional Care Coordination Services being provided.
The County Executive Office (CEO)
requests the Board approve Amendments for the renewal of the Contracts with
VOALA and PATH as referenced in the Recommended Actions above. Approval of the
Amendments will continue to support the County's effort to build a responsive
System of Care that meets the needs of different segments of the homeless
population in achieving housing stability.
FINANCIAL
IMPACT:
Appropriations for these Contracts
will be included in Budget Control 018 FY 2024-25 Budget Request and in the
budget process of the future years. These Contracts have no impacts on the
County General Fund.
The proposed funding sources are:
State: 100%
- Homeless Housing Assistance Program
allocation for the County [HHAP County 53%]
- Housing and Disability Advocacy Program
[HDAP 44%]
- Encampment Resolution Funding
Grant [ERF 3%]
The proposed Contracts include
provisions allowing CEO 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 CEO adequate time to transition or terminate
services to clients, if necessary.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A - Amendment No. 4 to Contract MA-017-23011657 with VOALA - Volunteers of
America of Los Angeles
Attachment B - Amendment No. 3 to Contract MA-017-23011656 with PATH - People
Assisting the Homeless
Attachment C - Redline to Contract MA-017-23011657
Attachment D - Redline to Contract MA-017-23011656
Attachment E - Contract Summary Form for MA-017-23011657
Attachment F - Contract Summary Form for MA-017-23011656