Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  24-000552

 

MEETING DATE:

05/20/25

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

3

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Veronica Kelley (714) 834-7024 

 

 

Ian Kemmer (714) 834-2160

 

 

Subject:  Approval of Contracts for Irvine Campus

 

      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 $17,625,120
FY 2026-27 $18,662,095
FY 2027-28 $18,662,095

 

 

 

    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:         N/A

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the Contract with Stars Behavioral Health Group, Inc., dba Coastal Star Behavioral Health, for provision of Adult Crisis Residential Services Irvine Campus, for the term of July 1, 2025, through June 30, 2028, for an amount not to exceed $10,586,382, renewable for one additional two-year term.

 

2.

Approve the Contract with Stars Behavioral Health Group, Inc., dba Coastal Star Behavioral Health for provision of Crisis Stabilization Services Irvine Campus, for the term of July 1, 2025, through June 30, 2028, for an amount not to exceed $27,862,634, renewable for one additional two-year term.

 

3.

Approve the Contract with Phoenix House Orange County, Inc. for provision of Drug Medi-Cal Co-Occurring Residential Treatment Services Irvine Campus, for the term of July 1, 2025, through June 30, 2028, for an amount not to exceed $10,800,000, renewable for one additional two-year term.

 

 

4.

Approve the Contract with Phoenix House Orange County, Inc. for provision of Sobering Center Services Irvine Campus, for the term of July 1, 2025, through June 30, 2028, for an amount not to exceed $5,700,294, renewable for one additional two-year term.

 

5.

Pursuant to Contract Policy Manual Section 3.3-113, authorize the County Procurement Officer or Deputized designee, to exercise a contingency contract cost increase not to exceed 10 percent of the contract amount for the first year of the contract for Adult Crisis Residential Services Irvine Campus;  10 percent of the contract amount for the first year of the contract for Crisis Stabilization Services Irvine Campus; 10 percent of the contract amount for the first year of the contract for Drug Medi-Cal Co-Occurring Residential Treatment Services Irvine Campus; 10 percent of the contract amount for the first year of the contract for Sobering Center Services Irvine Campus; for the entire term of the contracts including renewals, and within scope of work set forth in the contracts. The contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.

 

6.

Authorize the County Procurement Officer or Deputized designee to execute the contracts with Stars Behavioral Health Group, Inc. dba Coastal Star Behavioral Health and Phoenix House Orange County, Inc., as referenced in the Recommended Actions above.

 

 

 

 

SUMMARY:

 

Approval of the contracts with Stars Behavioral Health Group, Inc., dba Coastal Star Behavioral Health for Adult Crisis Residential Services and Crisis Stabilization Unit Services and Phoenix House Orange County, Inc. for Drug Medi-Cal Co-Occurring Residential Treatment Services and Sobering Center Services will allow for a continuum of Behavioral Health Services addressing both mental health and substance use disorders to be provided in one integrated setting at the Irvine Campus.  

 

 

 

BACKGROUND INFORMATION:

 

The Health Care Agency (HCA) is requesting the Honorable Board of Supervisors (Board) approval of the Contracts with Stars Behavioral Health Group, Inc., dba Coastal Star Behavioral Health (Coastal Star) for provision of Adult Crisis Residential (CRP) Services and Crisis Stabilization Unit (CSU) Services, and Phoenix House Orange County, Inc. (Phoenix House) for Drug Medi-Cal Co-Occurring Residential Treatment Services and Sobering Center Services (collectively, SUD) at the Irvine Campus.

 

On December 2, 2024, the HCA released two Request for Proposals (RFP) in the County’s online bidding system to solicit proposals to provide CRP and CSU services. The RFPs included the County’s intent to award one contract to the qualified respondent for each service whose proposal was determined to be the most responsive to the requirements of the RFP. On December 6, 2024, the HCA released one RFP in the County’s online bidding system to solicit proposals to provide SUD Services. HCA received by the deadline of January 6, 2025, five proposals for CRP Services and five proposals for CSU Services. HCA received by the deadline of January 10, 2025, seven proposals for SUD Services, with five responses for Drug Medi-Cal Co-Occurring Residential Treatment Services and six responses for Sobering Center Services. One Respondent was deemed non-responsive for SUD Services. The Orange County preference policy is not applicable to these contracts.

 

 

Proposal Evaluation Process

 

Evaluation panels were recruited to evaluate the proposals received for each RFP. CRP Services Panel consisted of subject matter experts; three HCA employees, one Social Services Agency (SSA) employee, and one external public member. CSU Services Panel consisted of: three HCA employees with subject matter expertise and two public members with subject matter expertise. SUD Services Panel consisted of three HCA employees with subject matter expertise and two SSA employees with subject matter expertise. Evaluation panel members independently rated the proposals using the following criteria and possible maximum points of 1000.

 

CRP Services:

Respondent

Average Score

Coastal Star

919.00

Telecare Corporation

856.33

Crestwood

799.67

Aliso Ridge Behavioral Health

787.00

Kleer Health Technologies, LLC dba Prosperous Health Response

766.00

The evaluation panel deemed the proposal and recommended award of contract to Coastal Star and no protests were received.

 

CSU Services:

Respondent

Average Score

Coastal Star

883.67

Kleer Health Technologies, LLC dba Prosperous Health Response

847.33

Telecare Corporation

832.67

Aliso Ridge Behavioral Health

765.00

CHCM, Inc.

734.33

The evaluation panel deemed the proposal and recommended award of contract to Coastal Star and no protests were received.

 

SUD Services:

Drug Medi-Cal Co-Occurring Residential Treatment Services

Respondent

Average Score

Phoenix House Orange County, Inc.

956.33

HealthRIGHT 360

910.33

Clean Path Recovery Response

886.33

Kleer Health Technologies, LLC dba Prosperous Health Response

882.33

God's Love Ministries

808.00

 

Sobering Center Services

Respondent

Average Score

Phoenix House Orange County, Inc.

943.67

HealthRIGHT 360

881.67

Kleer Health Technologies, LLC dba Prosperous Health Response

878.00

Clean Path Recovery Response

836.67

God's Love Ministries

807.00

Pamoja Advanced Nursing Practice Response

698.67

The evaluation panel deemed the proposal and recommended award of contract for Drug Medi-Cal Co-Occurring Residential Treatment Services and Sobering Center Services to Phoenix House and no protests were received.

 

HCA staff have conducted due diligence on the Respondents. Below are the reference checks, which have been confirmed as satisfactory. 

 

Respondent

Reference Check

Reference Check

Reference Check

Coastal Star

Los Angeles County Department of Mental Health

Fresno County Department of Behavioral Health

San Bernardino County Department of Behavioral Health

Phoenix House Orange County, Inc.

Los Angeles County Department of Public Health- Substance Abuse Prevention and Control Bureau

San Bernardino County Department of Behavioral Health

Tulare County Probation Department

 

HCA verified there are no concerns that must be addressed with respect to the Respondents’ ownership/name, litigation status or conflicts with County interest. HCA has confirmed that the appropriate due diligence has been conducted and all non-profits have been verified to be in good standing.

 

Scope of Services 

The Irvine campus will provide Orange County adults and adolescents experiencing mental health crisis, twenty-four (24) hours, seven days a week, access to psychiatric evaluations, treatment and stabilization in the CSU. Adults may be diverted from psychiatric hospitalization via a short-term stay in the CRP at the campus. Adults who are under the influence of drugs or alcohol may be diverted from jails or the emergency room to the Sobering Center and from there have the opportunity to be served in the co-occurring capable SUD Withdrawal Management and Residential Treatment program. The campus will have additional SUD services and Sobering Center Services designed to serve individuals that are intoxicated and in need of a safe place to become sober.

 

CRP Services:

The Irvine CRP will provide services to Orange County residents 18 years of age and older. CRP services provide short term, temporary alternatives for people experiencing acute psychiatric episodes or intense emotional distress who might otherwise face voluntary or involuntary inpatient treatment. Services include crisis intervention, therapy, medication monitoring and evaluation to determine the need and intensity of additional services within a framework of evidence-based and trauma-informed approaches to recovery planning, including a rich peer support component. The program will include treatment for co-occurring disorders. The programs emphasize mastery of daily living skills and social development using strength-based approaches that support recovery and wellness. The residential settings create solid links to the Continuum of Care with emphasis on housing supports and linkages that will ease the transitions into independent living and prevent psychiatric rehospitalization. 

 

This program operates 24 hours a day, seven days a week, emulating a home-like environment and supporting a social rehabilitation model, designed to enhance clients’ social connections with family or community to help them reintegrate into the community and prevent inpatient stays. Services will involve families and significant others throughout the treatment episodes so that the dynamics of the clients’ circumstances are improved prior to discharge. Clients are referred from Adult and Older Adult Behavioral Health County or County-contracted behavioral health providers. Services include collaborating with existing behavioral health providers to arrange for discharge planning, appropriate housing placements, as needed, in addition to securing linkages to ongoing treatment providers.  The average length of services is three weeks.

 

CSU Services:

CSU Services include, but are not limited to, 24 hours a day, seven days a week, medical services by psychiatrists and other advanced medical practitioners, individual and group therapy, nursing assessment, case management services with significant others, individual and family education, psychiatric evaluations and medication services, crisis intervention, and assessment for voluntary and involuntary treatment with transfer to inpatient care as appropriate. These services are provided for up to 24 hours and include coordination of referrals to continued care with mental health and substance use treatment providers, as well as other support services prior to discharge. Additionally, Peer Mentors are available to provide direct support, education and advocacy, as well as resource and linkage assistance to clients. The Peer Mentors are also mobile and continue to provide such services for identified clients for a period of time following discharge to ensure linkage to continuing care. The CSU operates on a 24 hours, seven days per week basis, 365 days a year.

 

 

SUD Services:

The campus will offer two SUD programs: the first program, Drug Medi-Cal Co-Occurring Residential Treatment program provides both withdrawal and residential treatment services. The residential treatment is for adults that meet medical necessity for substance use disorders. Treatment will consist of individual counseling, evidence based clinical and psycho-educational groups, care coordination with mental and physical health care services, access to Medication Assisted Treatment services, and other ancillary services. Treatment will also consist of providing stabilization to individuals that have a co-occurring condition.  

 

The second program, the Sobering Center, will provide a safe location for individuals experiencing intoxication from alcohol or other substances.  Services include observation and monitoring as well as care coordination to other services upon discharge.  

 

Performance Outcomes:

 

CRP Services:

The performance outcomes for the CRP are below:

A minimum of 75% of Clients shall be discharged to a lower level of care.

A minimum of 70% of Clients shall be linked to a continuing care provider.

A minimum of 95% of Clients shall not require hospitalization within 48 hours of discharge.

A minimum of 75% of Clients shall not require readmission within 14 calendar days of discharge.

 

CSU Services:

The performance outcomes for the CSU Services are below:

At least 55% of Clients admitted shall be successfully stabilized and returned to the community.

95% of Clients will be seen by a doctor within one hour of admission. 

Sustain an average daily census of 22 unduplicated clients per day based upon the number of recliners proposed.

85% success rate of linking discharged clients to a lower level of care within 10 business days.

 

SUD Services:

The performance outcomes for Drug Medi-Cal Co-Occurring Residential Treatment Services are below: 

Demonstrate provision of effective withdrawal management services as measured by at least 70% of clients exit the program making satisfactory progress.

Increase linkage to other levels of substance use disorder services, as measured by at least 30% of clients exiting the program attend at least one treatment service within 30 days of exiting the program.

 

The performance outcome for the Sobering Center Services is below:

Provide linkage through a warm handoff to ongoing physical health and/or behavioral health treatment as deemed appropriate.

Track barriers to linkage to care and what solutions were provided, e.g., transportation, childcare, unhoused, etc.

Use an evidence-based tool such as Screening, Brief Intervention, and Referral to Treatment (SBIRT) or Motivational Interviewing to engage in screenings and referrals.

 

The Contracts include subcontractors. See Attachment E for information regarding subcontractors and Contract Summary Forms.

 

HCA requests that the Board approve the Contracts with Coastal Star for provision of CRP Services, Coastal Star for provision of CSU Services and Phoenix House for provision of SUD Services, as referenced in the Recommended Actions above.

 

 

 

FINANCIAL IMPACT:

 

Funding Source:

 

State: 47% (Mental Health Services Act, Behavioral Health Services Act, State General fund and Realignment, Opioid fund)

Federal: 7% (Substance Use Prevention, Treatment, and Recovery Services Block Grant)

Fees/Other: 46% (Medi-Cal Federal Financial Participation, Drug Medi-Cal Federal Financial Participation)

 

Appropriations for this Contract will be included in Budget Control 042 FY 2025-26 Budget and will be included in the budgeting process for future years. 

 

The Contract includes provisions allowing HCA to terminate the Contract, reduce the level of services, and/or renegotiate the levels of services provided, as necessary. his includes a notice that allows HCA adequate time to transition or terminate service to clients, if necessary. ppropriations for this Contract are included in Budget Control 042 FY 2025-26 Budget and will be included in the budgeting process for future years.

 

 

 

STAFFING IMPACT:

 

N/A

 

 

 

ATTACHMENT(S):

 

Attachment A - Contract MA-042-25011433 for Adult Crisis Residential Services Irvine Campus
Attachment B - Contract MA-042-25011432 for Crisis Stabilization Services Irvine Campus
Attachment C - Contract MA-042-25011434 for Drug Medi-Cal Co-Occurring Residential Treatment Services Irvine Campus
Attachment D - Contract MA-042-25011435 for Sobering Center Services Irvine Campus
Attachment E - Contract Summary Forms
Attachment F - Score Sheets for Adult Crisis Residential Services
Attachment G - Score Sheets for Crisis Stabilization Unit Services
Attachment H - Score Sheets for Substance Use Disorder Services