Agenda Item   



                                                                                                                        ASR Control  22-000841




legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Annette Mugrditchian (714) 834-5026 



Veronica Kelley (714) 834-7024



Subject:  Renewal of Contract for Warmline Services


      ceo CONCUR

County Counsel Review

Clerk of the Board


Approved Agreement to Form




3 Votes Board Majority




    Budgeted: N/A

Current Year Cost:   N/A

Annual Cost: FY 2023-24: $12,000,000
FY 2024-25: $12,000,000




    Staffing Impact:


# of Positions:            

Sole Source:   Yes

    Current Fiscal Year Revenue: N/A

   Funding Source:     State: 100% (Mental Health Services Act/Prop 63)

County Audit in last 3 years: No

   Levine Act Review Completed: Yes


    Prior Board Action:         6/22/2021 #44, 6/2/2020 #15






Approve Amendment No. 7 to renew the Contract with NAMI Orange County for provision of Warmline Services for the term of July 1, 2023, through June 30, 2025, for an amount not to exceed $24,000,000 for a revised cumulative Contract total amount not to exceed $28,374,814.



Authorize the County Procurement Officer or Deputized designee to execute Amendment No. 7 to the Contract with NAMI Orange County as referenced in the Recommended Action above.






Approval of Amendment No. 7 to renew the Contract with NAMI Orange County for Warmline Services will ensure toll free 24-hour, seven days a week on-demand peer based non-crisis telephone, live chat and texting service is available to any Orange County resident needing behavioral health support.








On June 2, 2020, your Honorable Board of Supervisors (Board) approved the Contract with NAMI Orange County (NAMI) for provision of Warmline Services (Warmline) and all other Amendments were executed under Deputy Purchasing Agent delegated authority. The Orange County Preference Policy is not applicable to this Amendment.


Prior Board Actions

Board Date




June 2, 2020


Board Approved Contract

July 1, 2020 – June 30, 2023


June 22, 2021


Amendment No. 4

Board Approved Contract

July 1, 2021 – June 30, 2023



The proposed Amendment will allow the Warmline services to transform its present 24-hour telephone operations including voicemail function with callback options into a 24-hour call center-styled on-demand operation for the term of July 1, 2023, through June 30, 2025. The proposed Amendment will increase funds by $10,551,335 with an amount not to exceed $12 million per fiscal year, for a revised cumulative contract total amount not to exceed $28,374,814. This increase was approved for FY 2023-25 in the Annual Mental Health Service Act (MHSA) Plan Update for FY 2022-23. Continuation of the Warmline as an on-demand operation will improve the existing call response time and provide access to on-demand emotional support for residents of Orange County.  


Scope of Services

The Warmline is a peer-based, toll-free, 7 days a week (24/7) non-crisis, confidential telephone, live chat and texting service available to any Orange County resident needing behavioral health support. The goal of the Warmline is to provide timely emotional support to individuals who are experiencing grief, sadness, anxiety, anger, fear or loneliness and to reach those who are hesitant to seek behavioral health services due to stigma or other social factors.


NAMI has seen a steady increase in demand for its Warmline services over the past few years. Since FY 2020-21, when the Warmline was made into a 24/7 operation, the call volume has increased at a steady 20 percent or more per year and during these last two years in particular, the program’s infrastructure has largely outgrown its capacity to meet this demand. The proposed Amendment will enhance the Warmline services to meet comprehensive 24/7 program needs to include an “on demand” access to services via telephone, chat and text and eliminate the voicemail feature. The provider will make technological enhancements by upgrading the present phone system to an on-demand call operation, that will include the automation of call routing, remote coverage, integration of the phone system with data collection, and 24-hour managed Internet Technological (IT) solutions. The proposed funding will cover dedicated bilingual Vietnamese and Spanish language capacity of the 24/7 on-demand call center operation, as well as expand its outreach to these ethnic communities, through a subcontract with Abrazar for Spanish language staffing and with the Warner Wellness Center for Vietnamese language staffing, respectively. Additionally, it will increase overall program staffing including bilingual staffing coverage for Farsi and Korean languages as well.


The Warmline utilizes peer-based bilingual staff and volunteers providing services in English, Spanish, Vietnamese and Farsi as well as the language line providing assistance in other languages as needed. The Warmline is confidential and anonymous, and the availability of chat and text support provides callers with emotional support, including to those who are hearing impaired. Services are provided by staff or volunteers with similar lived experience as the caller and are trained in evidence-based practices to provide non-judgmental support. All incoming calls are screened for imminent safety concerns and, if needed, callers are immediately linked to the National Suicide Prevention Lifeline. The Warmline is widely publicized via outreach in the community.


Performance Outcomes


Table 1: Total Warmline Calls


FY 2020-21

FY 2021-22

FY 2022-23

July through April

Total call volume





The number of calls to the Warmline have been increasing steadily over time. At its inception, the NAMI OC volunteer Support Line operators received an average of 140 calls per month from consumers and family members. In comparison, in FY 2020-21, the program received an average of over 7,200 calls/chats/texts a month. The call volume continues to trend upward. In FY 2021-22 the call volume per month averaged over 10,000 calls and most recent data from the current fiscal year indicates that calls are averaging to over 11,000 per month.


Performance outcomes for the proposed Amendment are consistent with current year goals and will demonstrate an improvement in one or more mood states as measured by the Profile of Mood States Scale, a validated and published instrument that measures the change in mood over the course of the call. Outcomes data is analyzed at the end of each fiscal year. It should be noted that the program reports that the intensity of emotions expressed by callers has been heightened, and the callers’ presenting problems, have required additional support to address the current stressors impacted by current socioeconomic issues.


Table 2: Outcomes


Improvement in

FY 2020-21

Improvement in

FY 2021-22

The majority of the participants will demonstrate an improvement in one or more mood states as measured by the Profile of Mood States scale




The performance outcome results indicate that the Warmline Services continue to benefit the community by providing emotional support to callers. The proposed Amendment continues to be a Sole Source. Currently, there is no other Warmline service of this comprehensive nature with bilingual capability available in California and no other identified provider of this type of peer-to-peer, consumer run, evidence-based recovery-oriented type of services in Southern California. During the last solicitation for these services in February 2015, a Request for Proposals (RFP) for Warmline Services resulted in only one proposal received from NAMI that was deemed responsive by the evaluation committee. NAMI is recognized as the pioneer of the Warmline services in California. Initially created as a volunteer Support Line service to provide emotional support and connect callers to community resources in Orange County more than 15 years ago, the Warmline was formally launched in October of 2010, through an Agreement with the Health Care Agency to address the growing need for such a service. NAMI is recognized as the expert in this service, frequently providing consultation to other counties as well as the State of California to assist them with setting up their own Warmline services.


The Contractor's performance has been confirmed as satisfactory. The Health Care Agency (HCA) has verified there are no concerns that must be addressed with respect to Contractor's ownership/name, litigation status or conflicts with County interests.


The proposed Amendment with NAMI for Warmline Services will include subcontractors. See Attachment B for subcontractor information and Contract Summary Form.


HCA requests that the Board approve Amendment No. 7 to the Contract for provision of Warmline Services with NAMI, as referenced in the Recommended Actions.






Appropriations for this Contract will be included in Budget Control 042 FY 2023-24 Budget and will be included in the budgeting process for future years.


The Contracts include provision 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 participants, if necessary.











Attachment A – Amendment No. 7 to Contract MA-042-20011424 for Warmline Services with NAMI Orange County
Attachment B - Contract Summary Form
Attachment C - Redline Version to Attachment A