Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  19-000119

 

MEETING DATE:

06/04/19

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

3

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Annette Mugrdtichian (714) 834-5026 

 

 

Jeff Nagel (714) 834-7024

 

 

Subject:  Renewal of Agreement for Behavioral Health Services for Children and Youth

 

      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 2019-20 $1,576,574

 

 

 

    Staffing Impact:

No

# of Positions:

Sole Source:   No

    Current Fiscal Year Revenue: N/A

  Funding Source:      State:  62% (Mental Health Services Act/Prop 63), Other:  38% (Federal Financial Participation Medi-Cal)

County Audit in last 3 years: No

 

 

    Prior Board Action:          05/24/2016 # 44, 06/23/2015 #52

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the renewal of the Agreement with Children's Hospital of Orange County, dba CHOC Children's, for provision of Behavioral Health Services for Children and Youth for the period of July 1, 2019, through June 30, 2020, for a total maximum obligation of $1,576,574, and for a revised cumulative total amount not to exceed $7,305,922.

 

2.

Authorize the Health Care Agency Director, or designee, to exercise a contingency contract cost increase not to exceed 10 percent of the first year funding of the Agreement with Children's Hospital of Orange County, dba CHOC Children's, for the entire term of the Agreement 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 there is an increase in the projected services needed for the clients being served.

 

3.

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

 

 

 

 

SUMMARY:

 

Approval of the renewal Agreement with Children's Hospital of Orange County dba CHOC Children's will allow for provision of Behavioral Health Services for Children and Youth with co-occurring behavioral and physical health issues and their family members.

 

 

 

 

BACKGROUND INFORMATION:

 

On June 23, 2015, your Honorable Board of Supervisors (Board) approved the selection of and the Agreement with Children's Hospital of Orange County dba CHOC Children's (CHOC) for the provision of Behavioral Health Services for Children and Youth for the period of July 1, 2015, through June 30, 2016. On May 24, 2016, the Board approved a renewal for the period of July 1, 2016, through June 30, 2019; renewable for one additional one-year period. The current Agreement will end on June 30, 2019. The proposed agreement for July 1, 2019, through June 30, 2020, will allow for the continuation of services for children and youth with co-occurring behavioral and physical health issues. Prior to contract expiration, the Health Care Agency (HCA) plans to issue a solicitation to continue services.

 

The CHOC Co-occurring program (Program) emphasis is on clients whose behavioral health issues are interfering with engagement in medical treatment. Services are provided at a level, frequency and duration that is consistent with each client’s level of need and treatment goals that are consistent with individualized, solution-focused and evidence-based practices. Referrals are made by CHOC specialty clinics or CHOC physicians.  The population served includes children and youth with co-occurring medical diagnoses in the contractor's specialty clinics, including but not limited to neurology, endocrinology, gastroenterology, cardiology, oncology, metabolic disorders, urology, pulmonology and orthopedics. Included are children and youth with co-occurring medical diagnoses who are transitioning to home and adjusting to their physical health issues in the community. The services include individual, group and family psychotherapy, case management, crisis intervention and medication management.

 

The Program is using the Youth Outcome Questionnaire (YOQ) 2.0, a 64 item internationally used and validated measure of symptom change. The YOQ measures various areas of mental and behavioral health, including but not limited to interpersonal distress, somatic concerns, interpersonal relations, social problems and behavioral dysfunction. The questionnaire is administered monthly during the course of treatment.

 

Of the 445 clients served for FY 2017-18, 55 percent reported mental health distress levels that were either in a healthy or reliably improved category at the most recent administration of the YOQ. Preliminary results indicate that the program's services are associated with preventing symptoms of mental illness from becoming severe and disabling, as well as with a meaningful reduction in suffering among those who reported clinically-elevated distress upon entering the program and/or shortly after beginning treatment.

 

During the current agreement period, CHOC increased the total number of clients served. The following are total clients served during the first two full years of the Agreement and six months of the current fiscal year:

 

 

FY 2016-17

FY 2017-18

July 2018-Dec 2018

Clients Served

349

445

275

 

The contractor's performance has been confirmed as satisfactory. 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. This Agreement does not currently include subcontractors or pass through to other providers. See Attachment B for Contract Summary Form.

 

HCA requests the Board authorize the HCA Director, or designee, to exercise a contingency contract funding increase not to exceed 10 percent of the first year funding of the Agreement with CHOC, to be used over the entire term of the Agreement 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 there is an increase in the projected services needed for clients being served.

 

HCA requests that the Board approve the renewal of the Agreement with CHOC for provision of Behavioral Health Services for Children and Youth as referenced in the Recommended Actions.

 

 

 

FINANCIAL IMPACT:

 

Appropriations for this Agreement will be included in the FY 2019-20 Budget.

 

Should services need to be reduced or terminated due to lack of funding, this Agreement contains language that allows HCA to give 30-days' notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

 

 

 

STAFFING IMPACT:

 

N/A

 

ATTACHMENT(S):

 

Attachment A - Agreement with Children's Hospital of Orange County dba CHOC Children's for Provision of Behavioral Health Services for Children and Youth
Attachment B - Contract Summary Form
Attachment C - Redline Version of Attachment A