AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 18-000079
MEETING DATE:	03/27/18
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):	Jeff Nagel (714) 834-7024
	Mary Hale (714) 834-6032

Subject: Ratify Retroactive Approval of General Population Full Service Partnership

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $2,621,417

Annual Cost: FY 2018-19 $4,873,513
FY 2019-20 $4,313,051

Staffing Impact:

# of Positions:

Sole Source: No

Current Fiscal Year Revenue: N/A

Funding Source: See Financial Impact Section	County Audit in last 3 years: No

Prior Board Action: 2/15/2018 #1, 6/6/2017 #34

RECOMMENDED ACTION(S):

Approve and ratify the selection of and Agreement with Telecare Corporation for provision of General Population Region C Full Service Partnership Services for the period retroactive from March 1, 2018, through June 30, 2020, with a maximum obligation of $11,807,981.

Authorize the Health Care Agency Director or designee, to exercise a contingency contract cost increase in an amount not to exceed 10% of the first year of funding for the Agreement with Telecare Corporation for the entire term and within the scope of work set forth in the Agreements, pursuant to Contract Policy Manual Section 3.3-113.

Authorize the Health Care Agency Director, or designee, to execute the Agreement, as referenced in the Recommended Actions above.

SUMMARY:

The Health Care Agency requests ratification of the selection of and Agreement with Telecare Corporation for provision of General Population Full Service Partnership Services to serious and persistently mentally ill adults, age 18 to 59 years who may be homeless or at risk of homelessness in Orange County.

BACKGROUND INFORMATION:

On December 23, 2016, the Health Care Agency (HCA) issued a Request for Proposals (RFP) to seek qualified providers for various Full Service Partnership (FSP) services. FSP services are community-based and recovery-focused, and include intensive case management, counseling and therapy, housing support, medication support, vocational and educational support, and 24 hours per day, seven days per week access to staff for emergency needs.

On June 6, 2017, your Honorable Board approved the selection of and Agreements with Telecare Corporation (Telecare) for provision of General Population FSP for Regions A (North) and B (South) for the period of July 1, 2017, through June 30, 2020. Telecare is the current provider of General Population FSP services for Regions A and B. The program in Region C was originally intended to target the West region. However, with the growing number of individuals who are mentally ill and homeless in the Central region, the new proposed program will be centrally located. Individuals relocated as a result of the environmental remediation project along the Orange County Flood Control District will be served by this program.

The General Population FSP program serves adults, age 18 to 59 years, who have severe mental illness and/or co-occurring substance use disorders, and are homeless or at risk of homelessness, unserved or underserved, or not successfully engaged in traditional mental health services. Referrals come from the community. The General Population FSP program in Region A has 235 slots and targets individuals living in North Orange County. The General Population FSP program in Region B has 112 slots and targets individuals living in South Orange County. The new General Population FSP program will have 150 slots and targets individuals living in Central Orange County.

Outcomes

The anticipated outcomes are to improve the clients' functioning within the community, as measured by an increase in employment days or members engaged in educational activities, and a decrease in hospitalization, incarceration and/or homelessness days. These outcomes are measured by a pre- and post-comparison of the number of days clients are impacted by these circumstances while enrolled in the program, and compared against the 12-month period immediately prior to their enrollment. During FY 2016-17, the General Population FSP (Regions A and B) served 463 clients. Outcome data for FY 2016-17 are listed below. Overall, there was substantial decrease in homelessness days, hospitalization days and incarceration days. The performance of the existing provider has been satisfactory.

General Population FSP		Employment Activities (Days)		Educational Activities (Members)		Hospitalization Days			Incarceration Days			Homelessness Days
	Prior		Since	Prior	Since	Prior	Since	Prior		Since	Prior		Since
Region A	7,582		10,182	21	18	5,537	1,979	3,711		1,447	21,876		8,037
Region B	8,362		9,959	13	10	3,733	1,362	2,730		428	11,032		4,070
TOTAL	15,944		20,141	34	28	9,270	3,341	6,441		1,875	32,908		12,107

The funding for the proposed Agreement is identified below:

Period 1	Period 2	Period 3
$2,621,417	$4,873,513	$4,313,051

The proposed Agreement with Telecare Corporation for provision of General Population FSP Services will have subcontracts. See Attachment B for Contract Summary.

This contract is retroactive because Telecare’s regional responsibilities have changed after its original contract was approved by the Board. As a result of the Board action at the special meeting held on February 15, 2018, in response to the environmental remediation project, Telecare now serves the Central region as well. Telecare began servicing individuals relocated as a result of the environmental remediation project along the Orange County Flood Control District on March 1, 2018. Because these services pertain to the Board action that took place on February 15, 2018, HCA is requesting retroactive ratification to assume financial responsibility for costs incurred associated with this project.

Health Care Agency requests that the Board ratify the retroactive Selection of and Agreement with Telecare Corporation for provision of the General Population FSP Services as referenced in the Recommended Actions.

HCA requests that the Board authorize the HCA Director, or designee, to amend, as needed, the maximum obligation of the proposed Agreement by an amount not to exceed 10% of the first year of funding for the Agreement over the entire term and within the scope of work set forth in the Agreement, pursuant to Contract Policy Manual Section 3.4-114. The contingency provision would be exercised in the event of an unanticipated increase in the projected services needed for the clients being served.

In 2017, Orange County’s Point in Time (PIT) count recorded 4,792 homeless persons (2,208 sheltered, 2,584 unsheltered) within Orange County. Since bringing the Director of Care Coordination on board in May 2016, the County has concentrated its efforts on building a responsive “System of Care” in Orange County that reflects investments from diverse stakeholders while increasing the availability of shelter beds, recuperative care, crisis stabilization units and permanent supportive housing. The program in this ASR contributes to the overall “System of Care” in addressing the needs of those experiencing homelessness in Orange County.

FINANCIAL IMPACT:

Appropriations for this Agreement is included in the FY 2017-18 Modified Budget and will be included in the budgeting process for future years.

Funding Sources:

State: 89% (Mental Health Services Act/Prop 63)

Fees/Other: 11% (Federal Financial Participation Medi-Cal)

Should services need to be reduced or terminated due to lack of funding, the Agreement contains language that allows HCA to give 30 days' notice to either terminate or renegotiate the level of services to be provided. Additionally, the RFP states in part that HCA reserves the right to modify RFP; cancel the solicitation at any time, in whole or in part; reject any or all Applications; contract for all or some of the stated services; and/or based upon the County's needs or availability of funding at the time of selection or during contract negotiations, modify the scope of services described herein.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Agreement for Provision of General Population Full Service Partnership Services between County of Orange and Telecare Corporation
Attachment B - Contract Summary Form
Attachment C - Scoring Summary
Attachment D - Risk Management Form