Agenda Item AGENDA STAFF REPORT ASR Control 23-000897
MEETING DATE:	11/28/23
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	2
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Annette Mugrditchian (714) 834-5026
	Veronica Kelley (714) 834-7024

Subject: Contract for Multi-Service Center for Homeless Adults with Mental Disorders

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $1,231,171

Annual Cost: FY 2024-25 $1,231,171

Staffing Impact:

# of Positions:

Sole Source: N/A

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: 6/6/2023 #33, 4/26/2022 #21, 4/27/2021 #16, 6/5/2018 #18

RECOMMENDED ACTION(S):

Approve the selection of and Contract with Orange County Association for Mental Health dba Mental Health Association of Orange County for provision of Multi-Service Center Services for homeless adults with mental disorders for the term of January 1, 2024, through December 31, 2024, for an amount not to exceed $2,462,342, renewable for two additional two-year terms.

Pursuant to Contract Policy Manual Section 3.4-114, authorize the County Procurement Officer or Deputized designee to exercise a contingency contract cost increase, not to exceed ten percent of the Contract amount for the first year of the Contract, for the entire term of the Contract, including renewals, and within the scope of work set forth in the Contract. The use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.

Authorize the County Procurement Officer or Deputized designee to execute the Contract with Orange County Association for Mental Health dba Mental Health Association of Orange County as referenced in the Recommended Action above.

SUMMARY:

Approval of the selection and Contract with Orange County Association for Mental Health dba Mental Health Association of Orange County for the provision of Multi-Service Center Services for homeless adults with mental disorders will assist the County of Orange with providing linkages to temporary and permanent housing resources and supportive services for adults living with mental disorders experiencing homelessness in Orange County.

BACKGROUND INFORMATION:

On October 7, 2022, the Health Care Agency (HCA) released a Request for Proposal (RFP) in the County of Orange’s (County) online bidding system to solicit proposals from qualified providers for the provision of Multi-Service Center (MSC) Services for homeless adults with mental disorders. The RFP included the County's intent to award one contract to the qualified provider whose proposal was determined to be the most responsive to the requirements of the RFP. The solicitation went out to 12,515 organizations via the County’s online bidding system. HCA received one proposal by the RFP deadline of November 4, 2022, per the Contract Policy Manual 4.3-110, the project manager/department designee reviewed the proposal. HCA has completed successful negotiations and recommends awarding the contract to Orange County Association for Mental Health dba Mental Health Association of Orange County (MHA). MHA will provide MSC services in their Santa Ana location.

HCA staff have conducted due diligence on the provider. Reference checks were completed with Serve the People Community Health Center, Patriots and Paws and NAMI Orange County and were confirmed as satisfactory. The Orange County Preference Policy is not applicable to this Contract.

On June 5, 2018, your Honorable Board of Supervisors (Board) approved the prior Contract with MHA for provision of MSC Services for homeless adults with mental disorders. The below Board actions were executed pursuant to appropriate authorities. All other amendments were executed under Deputy Purchasing Agent authorities.

Board Date	Contract/Amendment	Action	Term
June 5, 2018	Contract	Board Approved Contract	July 1, 2018 - June 30, 2021
April 27, 2021	Amendment No. 3	Board Approved Term Renewal	July 1, 2021 - June 30, 2022
April 26, 2022	Amendment No. 5	Board Approved Term Renewal	July 1, 2022 - June 30, 2023
June 6, 2023	Amendment No. 6	Board Approved Term Extension	July 1, 2023 - December 31, 2023

Scope of Services

The MSC program offers a safe facility for adults 18 years of age and older, living with a mental disorder and who may have co-occurring substance use disorders and are experiencing homelessness. The MSC accepts referrals from several sources, including but not limited to, community partners; programs serving homeless adults suffering with mental disorders; and County outreach workers; community social service type agencies; as well as consumer referrals and walk-ins. The MSC provides an array of services to meet the most basic and immediate needs of adults including, but not limited to, access to showers and laundry facilities, nutritious snacks and beverages, the provision of a mailing address, clothing assistance and access to phones and internet to contact family or conduct a job search. MSC clients, which include homeless mentally ill veterans, also receive appropriate screening, assessment and linkage to mental health treatment and emergency housing, assistance with access to medical and dental services, benefits acquisition and additional food resources. MSC shall also provide permanent housing placement assistance and access to pre-vocational services and employment opportunities as available. In addition, MSC shall provide outreach efforts, counseling, groups, coping skills and life skills trainings, legal counsel, and other basic support and psychological wellness services to both the homeless and mentally ill and the homeless and mentally ill veterans. MSC shall operate Monday through Friday, 6:00 a.m. to 6:00 p.m. with the ability to serve 80 clients per day.

Performance Outcomes

Outcomes for linkages to permanent housing, number of veterans enrolled in the MSC, number of veterans enrolled in Veteran Affairs (VA) Resources and number of individuals gaining employment linked to mental health services were slightly below target for FY 2022-23, primarily due to staff vacancies and reduced hours which resulted in fewer referrals. Outcomes are shown below for FY 2022-23 and FY 2023-24 through September 30, 2023.

Performance Outcome Metrics

1st Quarter FY 2022-23

July 1, 2023 Through September 30, 2023

1st Quarter FY 2023-24

July 1, 2023 Through September 30, 2023

Ensure 2,000 Individuals referred to Supportive Services

905

934

Ensure 150 Individuals receive Pre-Vocational Services

Ensure 75 Individuals linked to Permanent Housing

Ensure 120 Veterans enrolled in the Multi-Service Center

Ensure 75 Veterans enrolled in VA Resources

Ensure 100 Individuals linked to Mental Health Services

Ensure 30 Individuals obtain employment

MHA’s performance has been confirmed as satisfactory and HCA will continue to work with MHA to strategize and develop plans that will assist MHA in meeting or exceeding all performance outcomes. MHA has taken steps to prioritize linkages, implementing the goal of linking all clients in 60 days to mental health services, and is on track to meet most performance outcome metrics by the end of this fiscal year. For permanent housing, MHA staff will continue to collaborate with community resources to ensure MSC clients are on a housing list for affordable housing. Although the number for MSC clients who are veterans enrolled is difficult to meet, MSC staff will continue to be responsive to community calls within Orange County, to ensure veteran outreach requests are completed. VA Resources will be met by MSC staff continuing their partnership with VA in Long Beach. MSC staff will continue to prioritize efforts for clients to obtain employment and secure shelter.

HCA has verified there are no concerns that must be addressed with respect to MHA’s ownership/name or conflicts with County interests. HCA has worked closely with MHA to address the concerns brought to their attention by the Board during the June 6, 2023, Board meeting, including the current litigation between the City of Santa Ana and MHA. It was determined by HCA that there are no concerns that will impact the proposed Contract.

HCA has developed a Good Neighbor Policy that is included as Exhibit D of the Contract. HCA will continue to work with MHA and the community to ensure positive community relations.

HCA requests that that Board authorize, pursuant to Contract Policy Manual Section 3.4-114, the County Procurement Officer or Deputized designee, to exercise a contingency contract cost increase in an amount not to exceed 10 percent of the contract amount for the first year of the contract, for the entire term of the Contract, including renewals, and within the scope of work set forth in the contract. The contingency provision would be exercised in the event there is an increase in the projected services needed for the clients being served. The use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.

This program supports the Prevention Pillar of the Homeless System Service Pillar strategy.

The proposed Contract does have a subcontractor. See Attachment B for Contract Summary Form.

HCA requests the Board approve the Contract for Multi-Service Center Services for homeless adults with mental disorders, as referenced in the Recommended Actions.

FINANCIAL IMPACT:

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

Funding Sources:

Federal: 32% (Homeless McKinney - Vento Funds - Projects for Assistance in Transition from Homelessness PATH Grant, and Mental Health Block Grant)

State: 68% (1991 Mental Health Realignment, 2011 Realignment - Managed Care, and Mental Health Service Act/PROP 63)

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

REVIEWING AGENCIES:

Office of Care Coordination

ATTACHMENT(S):

Attachment A - Contract MA-042-23011036 for the provision of Multi-Service Center Services Attachment B - Contract Summary Form