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Agenda Item
ASR
Control 22-000564 |
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MEETING DATE: |
08/09/22 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
1, 2 |
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SUBMITTING
Agency/Department: |
Health Care Agency
(Approved) |
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Department contact
person(s): |
Annette Mugrditchian (714) 834-5026 |
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Veronica Kelly (714) 834-7024 |
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Subject: Amendments for Full Service
Partnership/Wraparound Services
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ceo CONCUR |
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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: Yes |
Current Year Cost:
$4,500,347 |
Annual Cost:
FY 2023-24 $4,500,347 |
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Staffing Impact: |
No |
# of Positions:
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Sole Source:
No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 4/27/2021
#24 |
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RECOMMENDED ACTION(S):
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1. |
Approve Amendment No.1 to the Contract with Pathways Community Services, LLC. for provision of Children’s Full Service Partnership/Wraparound Services, increasing the not to exceed amount by $5,229,426 for a revised not to exceed amount of $15,404,796, for the term of July 1, 2022, through June 30, 2024, for a revised cumulative contract total amount not to exceed $20,492,481. |
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2. |
Approve Amendment No.1 to the Contract with Pathways Community Services, LLC. for provision of Transitional Age Youth Full Service Partnership/Wraparound Services, increasing the not to exceed amount by $1,992,084 for a revised not to exceed amount of $12,206,780 for the term of July 1, 2022, through June 30, 2024, for a revised cumulative contract total not to exceed $17,314,128. |
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3. |
Approve Amendment No.1 to and Contract with Orange County Asian and Pacific Islander Community Alliance, Inc. for provision of Children and Transitional Age Youth Full Service Partnership/Wraparound Services, increasing the amount by $1,779,184 for a revised not to exceed amount of $7,481,280 for the term of July 1, 2022, through June 30, 2024, for a revised cumulative contract total not to exceed $10,332,328. |
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4. |
Authorize the County Procurement Officer or Deputized designee to execute the Amendments to the Contracts with Pathways Community Services, LLC. and Orange County Asian and Pacific Islander Community Alliance, Inc., as referenced in the Recommended Actions above. |
SUMMARY:
Approval of the Amendments with Pathways Community Services, LLC. and Orange County Asian and Pacific Islander Community Alliance, Inc. for Children and Transitional Age Youth Full Service Partnership/Wraparound Services will provide individualized, strengths-oriented, client-driven services that are more intensive in nature than traditional outpatient services.
BACKGROUND INFORMATION:
On April 27, 2021, your Honorable Board of Supervisors (Board) approved the selection of and Contracts for provision of Children and Transitional Age Youth (TAY) Full Service Partnership/Wraparound (FSP/Wrap) Services with Pathways Community Services, LLC. (PCS) and Orange County Asian and Pacific Islander Community Alliance, Inc. (OCAPICA). The Orange County Preference Policy is not applicable to these Amendments.
The proposed Amendments will allow the following for each provider:
PCS’ Children’s FSP/Wrap amendment will increase salaries so the programs are in line with competitive wages in the current marketplace and increase staffing to expand outreach and engagement services to children in crisis.
PCS’ TAY FSP/Wrap amendment will increase salaries so the programs are in line with competitive wages in the current marketplace.
OCAPICA’s Children’s and TAY FSP/Wrap amendment will increase staffing including psychiatry services and increase salaries so the programs are in line with competitive wages in the current marketplace.
In accordance with the Mental Health Services Act of 2004, each FSP/Wrap program is directed at a specific target population for seriously emotionally disturbed (SED)/severely mentally ill (SMI) children and youth. The target populations are identified below:
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Provider |
Target Population |
Clients To Be Served |
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PCS Children’s FSP/Wrap |
Children and Youth (ages 18 years and younger) |
242 |
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PCS TAY FSP/Wrap |
Transitional Age Youth (ages 16 years through 25 years) |
260 |
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OCAPICA Children’s and TAY FSP/Wrap |
Culturally and Linguistically Isolated Children and Transitional Age Youth (ages 25 years and younger) |
106 |
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TOTAL |
608 |
Scope of Services
FSP/Wrap programs are, client-centered programs, family-focused where individualized, client-driven service plans are developed. FSP/Wrap programs provide services to clients experiencing a SED and/or a SMI. The programs focus on the strengths of the child, TAY and their families across all life domains in order to promote success in school, employment, safety, wellness and recovery through a “whatever-it-takes” approach. Consistent with the “whatever it takes” approach, the FSP/Wrap programs support clients participation in and engagement with mental health services through targeted funding (referred to as “flex funding”) for items such as, but not limited to, basic living expenses, housing, employment, specialty treatments and transportation. FSP/Wrap services include direct mental health care; medication support services; individual, group and family therapy; crisis intervention; case management; and supportive services in the community targeting job acquisition, school success and housing stability.
Performance Outcomes
Performance outcomes for these programs are measured by state mandated outcome measures. The FSPs evaluate outcomes related to days homeless, days psychiatrically hospitalized and days incarcerated by comparing functioning in the 12 months prior to enrolling in the FSP to functioning during the year being evaluated. PCS and OCAPICA were the prior providers for these services, and the prior contract performance outcomes are represented below.
PCS, Children and Youth FSP/Wrap services demonstrated a decrease in days homeless and psychiatrically hospitalized for FY 2019-20 and 2020-21. PCS experienced a total increase of nine incarceration days for two clients during the two reported fiscal years. Due to the elevated needs of the population that PCS serves, the program continues to engage clients while incarcerated rather than discharging them to ensure clients have supports in place within the community upon release to increase their chances of success. This continued support for clients throughout the period of incarceration results in an increase in the reported number of days incarcerated.
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PCS Children and Youth FSP/ Wrap |
Total Clients Served |
Reduction In Days Homeless for Those with Days Homeless Prior to
Enrollment |
Reduction In Days Psychiatrically Hospitalized for Those with Days
Psychiatrically Hospitalized Prior to Enrollment |
Reduction In Days Incarcerated for Those with Days Incarcerated Prior
to Enrollment |
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Pre Avg |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
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FY 2019-20 |
301 |
75.1 Days |
0 Days |
100% Decrease |
16.1 Days |
3.9 Days |
76% Decrease |
39.5 Days |
157.5 Days |
299% Increase |
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FY 2020-21 |
320 |
61.9 Days |
0 Days |
100% Decrease |
19.1 Days |
3.6 Days |
81% Decrease |
17 Days |
94 Days |
453% Increase |
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PCS, TAY FSP/Wrap, demonstrated a decrease in all areas for FY 2020-21.
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PCS TAY FSP/ Wrap |
Total Clients Served |
Reduction In Days Homeless for Those with Days Homeless Prior to
Enrollment |
Reduction In Days Psychiatrically Hospitalized for Those with Days
Psychiatrically Hospitalized Prior to Enrollment |
Reduction In Days Incarcerated for Those with Days Incarcerated Prior
to Enrollment |
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Pre Avg. |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
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FY 2019-20 |
322 |
122.5 Days |
13.4 Days |
89% Decrease |
27.4 Days |
6.1 Days |
78% Decrease |
98.2 Days |
5.7 Days |
94% Decrease |
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FY 2020-21 |
286 |
110.6 Days |
18 Days |
84% Decrease |
22.6 Days |
5.6 Days |
75% Decrease |
86.4 Days |
10.3 Days |
88% Decrease |
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OCAPICA demonstrated a decrease in days homeless and psychiatrically hospitalized for FY 2020-21. OCAPICA had no clients with incarceration days or homeless days pre- or post-enrollment during FY 2020-21.
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OCAPICA FSP/Wrap |
Total Clients Served |
Reduction In Days Homeless for Those with Days Homeless Prior to
Enrollment |
Reduction In Days Psychiatrically Hospitalized for Those with Days
Psychiatrically Hospitalized Prior to Enrollment |
Reduction In Days Incarcerated for Those with Days Incarcerated Prior
to Enrollment |
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Pre Avg. |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
Pre Avg. |
Post Avg. |
% Change |
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FY 2019-20 |
196 |
270 Days |
0 Days |
100% Decrease |
10.4 Days |
0.7 Days |
93% Decrease |
0 Days |
0 Days |
N/A |
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FY 2020-21 |
187 |
0 Days |
0 Days |
N/A |
15.6 Days |
2.1 Days |
86% Decrease |
0 Days |
0 Days |
N/A |
The Contracts include subcontractors. See Attachments D for information regarding subcontractors and Contract Summary Forms.
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.
HCA request that that Board approve the Amendments with PCS and OCAPICA, for the provision of Children’s FSP/Wrap Services with PCS, the provision of TAY FSP/Wrap Services with PCS and the provision of Children and TAY FSP/Wrap with OCAPICA, as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Appropriations for these Amendments are included in Budget Control 042 FY 2022-23 Budget and will be included in the budgeting process for future years.
The proposed Contract includes 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
ATTACHMENT(S):
Attachment A - Amendment No. 1 to Contract MA 042-21011160 for Children's
Full Service Partnership/Wraparound Services with Pathways Community Services,
LLC.
Attachment B - Amendment No.1 to Contract MA 042-21011162 for Transitional Age
Youth Full Service Partnership/Wraparound Services with Pathways Community
Services, LLC.
Attachment C - Amendment No.1 to Contract MA 042-21011159 for Children and
Transitional Age Youth Full Service Partnership/Wraparound Services with Orange
County Asian and Pacific Islander Community Alliance, Inc.
Attachment D - Contract Summary Forms for Attachments A-C
Attachment E - Redline to Attachment A
Attachment F - Redline to Attachment B
Attachment G - Redline to Attachment C