AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 19-001191
MEETING DATE:	12/10/19
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
	Jeff Nagel (714) 834-7024

Subject: Approve Participation Agreement with California Mental Health Services Authority

ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

3 Votes Board Majority

Budgeted: Yes

Current Year Cost: $204,416

Annual Cost: FY 2020-21 $459,935
FY 2021-22 $459,935
FY 2022-23 $459,935
FY 2023-24 $459,935

Staffing Impact:

# of Positions:

Sole Source: No

Current Fiscal Year Revenue: N/A

Funding Source: State: 100% (Mental Health Services Act/Prop 63)	County Audit in last 3 years: No

Prior Board Action: N/A

RECOMMENDED ACTION(S):

Approve Participation Agreement Number 493-EPLHCN-OC2019 with the California Mental Health Services Authority for the Statewide Early Psychosis Learning Health Care Network Innovation project for a total of $2,044,156 for the period of January 1, 2020, through December 31, 2024.

Authorize the Health Care Agency Director, or designee, to execute the Agreement in Recommended Action #1.

Direct the Auditor-Controller to distribute funds to the California Mental Health Services Authority upon the approval of the Participation Agreement referenced in Recommended Action #1.

SUMMARY:

Approval of the California Mental Health Services Authority Participation Agreement for the Statewide Early Psychosis Learning Health Care Network Innovation project will increase the quality of mental health services.

BACKGROUND INFORMATION:

In November 2004, the California voters approved Proposition 63, the Mental Health Services Act (MHSA). Components of the MHSA include Community Services and Supports, Workforce Education and Training, Prevention and Early Intervention (PEI), Innovation (INN) and Capital Facilities and Technological Needs. Five percent of MHSA funds are allocated to INN for the purpose of evaluating the effectiveness of new and/or changed approaches and practices in mental health services and supports.

On December 17, 2018, the Mental Health Services Oversight and Accountability Commission approved funding for the Statewide Early Psychosis (EP) Learning Health Care Network as a five-year INN project. The Health Care Agency (HCA) is requesting approval of a Participation Agreement with California Mental Health Services Authority (CalMHSA) to provide fiscal and administrative oversight of this project.

EP programs target individuals early in the course of mental illness, with a goal of preventing mental disorders from becoming severe and disabling. Over the last several years, there has been an expansion of EP services across California. As of 2017, 30 EP programs exist, serving consumers in 24 of the 58 counties in California. The Orange County Center for Resiliency, Education and Wellness (OC CREW) is the only HCA EP program. OC CREW serves young people, ages 12 to 25 years old, and the people in their lives by providing supportive services for those experiencing a first episode of psychotic illness. However, EP programs, like OC CREW, were started locally with little collaboration in training or implementation. As a result, there is significant variation in EP program delivery and implementation resulting in unknown impacts. This project will develop an EP learning health care network to support shared learning and development across the state, as well as assess impact and cost-effectiveness of EP programs.

This statewide project will be led by the University of California, Davis (UC Davis), and includes a collaboration with HCA’s OC CREW program. UC Davis will conduct interviews with OC CREW staff to gather information about current program assessments, data collection and tracking methods in order to identify a core set of outcome measures that will be implemented across counties participating in this project. Outcome results will be evaluated at a local and statewide level, which will enable EP programs to learn from each other and position the state to participate in the development of a national network to improve care for individuals across the United States with early psychosis.

Through the Joint Powers of Authority, CalMHSA will act as the fiscal intermediary and contracting agent for the Statewide EP Learning Health Care Network project on behalf of the County. The CalMHSA Participation Agreement contains a mutual indemnification provision that differs from the County’s standard sole indemnification practice and requires each party to indemnify, defend and hold harmless the other from and against any and all claims, losses, damages, liabilities, disallowances recoupments and expenses, including but not limited to reasonable attorney’s’ fees, arising out of or resulting from other’s negligence in the performance of its obligations under the Participation Agreement except to the extent the claims, etc., are the result of the negligence or willful misconduct of the party. CEO Risk Management has reviewed and approved the indemnification.

This Agenda Staff Report is being brought before the Board of Supervisors (Board) less than 30-days before the start of the contract term due to the urgency of moving the project forward, as this INN project will be implemented for a defined time-period of less than five years.

HCA requests that your Board approve the proposed Participation Agreement with CalMHSA for the Statewide EP Learning Health Care Network INN project and to distribute MHSA Innovation funds to CalMHSA for the implementation of the project, as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this project are included in Budget Control 042 FY 2019-20 Budget and will be included in the budgeting process for future years.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A – California Mental Health Services Authority Participation Agreement
Attachment B – Mental Health Services Oversight and Accountability Commission Innovation Project Approval Letter
Attachment C – Risk Assessment Form