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Agenda Item
ASR
Control 21-000977 |
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MEETING DATE: |
04/26/22 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
All Districts |
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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 Kelley (714) 834-7024 |
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Subject: Approval of Contracts for
Short Term Residential Therapeutic Programs
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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: N/A |
Current Year Cost:
N/A |
Annual Cost:
FY 2022-23 $14,000,000 |
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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: 04/27/2021
#22, 06/02/2020 #13, 04/23/2019 #21, 12/05/2017 #34 |
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RECOMMENDED ACTION(S):
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1. |
Approve the Master Agreement for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs for the term of July 1, 2022, through June 30, 2024, for an aggregate amount not to exceed $28,000,000. |
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2. |
Approve the individual Contract with Childhelp, Inc. for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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3. |
Approve the individual Contract with Hart Community Homes for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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4. |
Approve the individual Contract with Mary’s Shelter dba Mary’s Path for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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5. |
Approve the individual Contract with New Alternatives, Inc. for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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6. |
Approve the individual Contract with Olive Crest for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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7. |
Approve the individual Contract with Rite of Passage Adolescent Treatment Centers and Schools, Inc. for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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8. |
Approve the individual Contract with South Coast Children’s Society, Inc. for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs, for the term of July 1, 2022, through June 30, 2024. |
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9. |
Pursuant to Contract Policy Manual Section 3.4-114, authorize the Health Care Agency Director or designee, to exercise a contingency contract cost increase in an amount not to exceed $1,400,000 which is 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 use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer. |
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10. |
Authorize the County Procurement Officer or Deputized designee to execute the Master Agreement and execute individual contracts with Childhelp, Inc., Hart Community Homes, Mary’s Shelter dba Mary’s Path, New Alternatives, Inc., Olive Crest, Rite of Passage Adolescent Treatment Centers and Schools, Inc., South Coast Children’s Society, Inc., as referenced in the Recommended Actions above.
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11. |
Authorize the County Procurement Officer or Deputized designee to execute individual Contracts with various providers as needed throughout the term of the Master Agreement. |
SUMMARY:
Approval of the Master Agreement and individual Contracts with various providers for the provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs will provide intensive specialty mental health services to Wards and Dependents of the Court, ages six to 17, and Non-Minor Dependents, ages 18 to 20, placed in licensed Short-Term Residential Therapeutic Programs in Orange County, and in other counties where a waiver has been established.
BACKGROUND INFORMATION:
Your Honorable Board of Supervisors (Board) previously approved a Master Agreement for provision of Behavioral Health Services in Short-Term Residential Therapeutic Programs (STRTP) with various providers and the below additional actions related to the Master Agreement were executed pursuant to appropriate authorities.
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Board Date |
Contract /
Amendment |
Action |
Term |
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December 5, 2017 |
Master Agreement |
Board Approved Master Agreement |
January 1, 2018 - June 30, 2020 |
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April 23, 2019 |
Amendment No. 1 |
Board Approved Funding Increase |
January 1, 2018 - June 30, 2020 |
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June 2, 2020 |
Amendment No. 2 |
Board Approved Term Renewal |
July 1, 2020 - June 30, 2021 |
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April 27, 2021 |
Amendment No. 3 |
Board Approved Term Renewal |
July 1, 2021 - June 30, 2022 |
Scope of Services
Behavioral Health Services in STRTPs for Wards and Dependents of the Court and Non-Minor Dependents (NMD) were designed to reform congregate care for youth in California. As of January 1, 2017, Continuum of Care Reform (CCR, Assembly Bill 403) established a new community care licensure category for residential treatment programs called STRTP, and all facilities who were licensed as group homes, who wanted to continue providing services to children under the jurisdiction of the Juvenile Court, were required to transition to a new facility type, namely STRTP, by December 31, 2018. The California Department of Social Services (CDSS) processes the licenses for an existing group home to become a STRTP.
Not all Orange County group home providers met the initial deadline to receive STRTP licensure; therefore, CDSS granted the first one-year extensions through December 31, 2019, then subsequent extensions through December 31, 2020.
The legislation provides that once provisionally licensed by CDSS, STRTPs have 12 months to become fully accredited and permanently licensed. The transition process for STRTPs requires that they secure a mental health contract with the local Mental Health Plan (i.e., Health Care Agency) in order to become a certified Medi-Cal provider and obtain Mental Health Program approval from the Department of Health Care Services. This Master Agreement allows the Health Care Agency (HCA) to respond promptly to STRTPs that are provisionally licensed, allowing each STRTP to fully implement the mandated Behavioral Health Services for the Wards and Dependents of the Court and NMDs placed in STRTPs. Social Services Agency (SSA) provides the residential care and supervision for the youth placed at the STRTPs; whereas, HCA provides the Specialty Mental Health Services (SMHS) for these youth.
Since the approval of the Master Agreement on December 5, 2017, through January 2022, all seven group home providers in Orange County that applied for STRTP licensure have obtained permanent STRTP licenses. All seven providers are also contracted with HCA for SMHS, and the total aggregate number of beds is anticipated to meet the demand for STRTP level of care placements in Orange County. The following table provides the number of beds per facility and the district within which each facility is located:
Table 1: STRTP Facilities
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Providers |
No. of
Facilities |
No. of Beds |
City |
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FIRST DISTRICT |
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South Coast Children's Society, Inc. |
2 |
12 |
Fountain Valley |
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SECOND DISTRICT |
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Olive Crest |
1 |
6 |
Santa Ana |
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Olive Crest |
1 |
6 |
Orange |
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Providers |
No. of
Facilities |
No. of Beds |
City |
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SECOND DISTRICT |
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Mary’s Shelter dba Mary’s Path |
2 |
5 |
Santa Ana |
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Hart Community Homes |
2 |
12 |
Orange |
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New Alternatives, Inc. |
1 |
24 |
Orange |
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THIRD DISTRICT |
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Olive Crest |
1 |
6 |
Santa Ana |
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Rite of Passage Adolescent Treatment Centers and Schools, Inc. |
2 |
12 |
Tustin |
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FOURTH DISTRICT |
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Rite of Passage Adolescent Treatment Centers and Schools, Inc. |
2 |
12 |
Placentia |
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FIFTH DISTRICT |
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New Alternatives, Inc. |
1 |
16 |
Costa Mesa |
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Childhelp, Inc. |
3 |
15 |
Costa Mesa |
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South Coast Children’s Society, Inc. |
1 |
6 |
Costa Mesa |
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Total: |
19 |
132 |
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Performance
Outcomes
HCA is contracted for 132 beds with seven STRTP providers at 19 different facilities throughout Orange County. In FY 2020-21, there were 165 unduplicated clients served in STRTPs. The average length of stay for these youth is 263 days (8.8 months), much longer than the intended six-month timeline for the STRTPs. This is indicative of the intensive clinical needs of the youth served in the STRTPs, and the need for extended intensive treatment in order to stabilize and transition them to lower levels of care and longer-term family-based placements. The goal of the STRTPs is to provide intensive SMHS for the youth for the duration of the stay, and to transition them to a lower level of care. The chart below details the number of youth served in the STRTPs in FY 2019-20 and FY 2020-21, average length of stay, and the discharge numbers and destinations.
Table 2: Outcomes
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FY 2019-20 |
FY 2020-21 |
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Unduplicated clients served |
124 |
165 |
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Average Length of Stay |
298 days (9.9 months) |
263 days (8.8 months) |
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Discharged |
95 |
118 |
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Transferred to higher level of care (i.e. incarceration, hospitalization, etc.) |
18 |
18 |
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No discharge destination due to extended Absence Without Leave (AWOL) |
16 |
20 |
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Transferred to another STRTP (i.e. due to behavioral issues, safety concerns, commonality of need, etc.) |
19 |
19 |
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Transferred to a lower level of care placement (i.e. resource family home, transitional housing program, etc.) |
25 |
34 |
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Reunited with family/relatives or successfully transitioned into adulthood |
18 |
27 |
The individual contracts, due to the nature of the services, could require the addition of subcontractors. In order to add subcontractor(s) to the contract(s), the provider/contractor must seek express consent from HCA. Should the addition of a subcontractor affect the scope of work and/or contract amount, HCA will bring the item back to the Board for approval. See Attachments B regarding subcontracts and Contract Summary Form.
The Contractors’ performances have been confirmed as satisfactory. HCA has verified there are no concerns that must be addressed with respect to Contractors’ ownership/name, litigation status or conflicts with County interests.
Orange County Preference Policy is not applicable to this contract award.
HCA has developed a Good Neighbor Policy that is included in Residential Program contracts wherein contractor provides services to County residents and the services may have a potential impact on the surrounding neighborhood(s) including but not limited to environment, safety, and congregation. HCA has not received any negative feedback from the community and will continue to work with the contractor(s) and the community to ensure positive community relations.
HCA requests the authority to add new providers or locations without returning to the Board for approval as referenced in the Recommended Actions. Returning to the Board for approval of new providers may result in a delay that would compromise critical bed availability. The ability to add new, qualified providers is time sensitive due to the instability and needs of the at-risk population served under the Master Agreement. CCR requires the STRTPs to be contracted with the County Child Welfare Agency for residential care and supervision, and with the County Mental Health Plan for SMHS; therefore, HCA will need to contract in a timely manner with new providers who are licensed by CDSS and contracted with SSA in order to ensure the STRTP beds may be promptly utilized to serve this high-risk population.
Pursuant to Contract Policy Manual Section 3.4-114, authorize the HCA Director or designee, to exercise a contingency contract cost increase in an amount not to exceed $1.4 million which is 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 use of this contingency contract cost increase is subject to approval requirements established by the County Procurement Officer.
HCA requests that the Board approve the Master Agreement and individual contracts with various providers for the provision of Behavioral Health Services in STRTP, as referenced in the Recommended Actions.
FINANCIAL IMPACT:
Appropriations for this Contract will be 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 - Master Agreement for Behavioral Health
Services in Short-Term Residential Therapeutic Programs
Attachment B - Contract Summary Form
Attachment C - Assembly Bill 403
Attachment D - Contract MA-042-22011399 with Childhelp, Inc.
Attachment E - Contract MA-042-22011399 with Hart Community Homes
Attachment F - Contract MA-042-22011399 with Mary's Shelter dba Mary's Path
Attachment G - Contract MA-042-22011399 with New Alternatives, Inc.
Attachment H - Contract MA-042-22011399 with Olive Crest
Attachment I - Contract MA-042-22011399 with Rite of Passage Adolescent
Treatment Centers and Schools, Inc.
Attachment J - Contract MA-042-22011399 with South Coast Children's Society,
Inc.