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Agenda Item
ASR
Control 22-000955 |
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MEETING
DATE: |
05/23/23 |
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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: Renewal of Contract for Behavioral
Health Patients' Rights Advocacy
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ceo CONCUR |
County Counsel Review |
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 2023-24 $1,433,515 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: Yes |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 5/19/2020 #19 |
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RECOMMENDED
ACTION(S):
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1. |
Approve Amendment No. 1 to renew the
Contract with Mental Health Systems, Inc. for provision of Behavioral Health
Patients' Rights Advocacy Services for the term July 1, 2023, through June
30, 2025, for an amount not to exceed $2,895,600, for a revised cumulative
contract total amount not to exceed $7,098,319. |
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2. |
Authorize the Health Care Agency
Director, or Deputized designee to designate Mental Health Systems, Inc., as
the Orange County Patients' Rights Advocate with the duties and
responsibilities as stated in the Welfare and Institutions Code, Section
5520-5523. |
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3. |
Authorize the
County Procurement Officer or Deputized designee to execute Amendment No. 1,
to the Contract with Mental Health Systems, Inc., as referenced in the
Recommended Actions above. |
SUMMARY:
Approval of Amendment No. 1 to
designate/redesignate Mental Health Systems, Inc. as the Orange County
Patients’ Rights Advocate and renew the Contract with Mental Health Systems for
Behavioral Health Patients’ Rights Advocacy Services will provide Advocacy
services focused on the protection of the rights of persons with mental
illness.
BACKGROUND
INFORMATION:
California has a legislatively
mandated patients’ rights advocacy system made up of three components: (1)
County Patients’ Rights Advocates, (2) State Hospital Patients’ Rights
Advocates and (3) the California Office of Patients’ Rights. Each county mental
health director is required to designate, or contract for the services of,
Patients’ Rights Advocates (Welfare and Institutions Code (WIC) Section
5520).
All
recipients of mental health services, regardless of their means, mental or
physical health challenges, should expect to be treated respectfully and
without discrimination by their providers, practitioners and payers. People
receiving mental health treatment are protected by both state and federal laws,
to include all rights and responsibilities unless limited by court.
On May
19, 2020, your Honorable Board of Supervisors (Board) approved the selection of
and current Contract with Mental Health Systems, Inc. (MHS) for the provision
of Behavioral Health Patients’ Rights Advocacy Services (PRAS) for the term of
July 1, 2020, through June 30, 2023.
The proposed Amendment will allow
services and designation to continue for the renewal term of July 1, 2023,
through June 30, 2025, for an amount not to exceed $2,895,600, for a revised
cumulative contract total amount not to exceed $7,098,319. Prior to contract
expiration, HCA plans to issue a solicitation to continue services.
The Orange County Preference Policy
is not applicable to this Amendment.
Scope
of Services
MHS will provide Patients’ Rights
Advocacy Services in Orange County focused on the protection of the rights of
persons with mental illness as stated in the Welfare and Institutions Code
(WIC), Sections 5520-5523. Advocacy services provided include the following.
The provider will ensure information about patients’ rights is posted in all
facilities providing mental health services. MHS will also ensure that all new
clients current recipients of mental health services in licensed health and
community care facilities, are informed of their rights. MHS will receive and
investigate complaints from or concerning patients about violations or abuse of
their rights. They will monitor mental health facilities, services and programs
for compliance with patients’ rights laws, and train mental health providers
about these laws. Additionally, MHS will act as a consultant to staff in mental
health facilities in the area of patients’ rights, and advocate for patients
and residents who are unable or afraid to register a complaint. Lastly, they
will act as a liaison between the advocacy program and the California Office of
Patients’ Rights. MHS will work collaboratively with the Mental Health and
Recovery Services, Quality Management Services on all Medi-Cal beneficiary
complaints/grievances received and determine follow-up into complaints.
Performance
Outcomes
MHS shall act as the County
Patients’ Advocate designated by the local Behavioral Health Director with the
duties and responsibilities as stated in the WIC, Sections 5520-5523. The
Patients' Advocate will collaborate and act as a positive catalyst between
clients, Behavioral Health Services programs and providers and will provide
consultation, as needed, to the Behavioral Health Director or their designee on
issues involving the protection of rights for persons with mental illness.
MHS will provide a minimum of:
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FY
21-22 actuals |
FY
22-23 actuals (July through February) |
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A
minimum of 1,800 contacts per fiscal year |
21,025 |
17,780 |
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At
minimum, two onsite visits a week with inpatient facilities to ensure
compliance with patients’ rights regulations |
4 |
4 |
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Quarterly
walkthrough of all County inpatient psychiatric units to ensure compliance
with patients’ rights regulations.* |
On
average, 27 walkthroughs per quarter. |
On
average, 24 walkthroughs per quarter. |
*There are currently 25 inpatient
psychiatric units under the purview of patients’ rights advocacy services.
In
addition to the outcomes above, MHS PRAS provided a total of 265 trainings and
education courses in FY 21-22 and 115 in FY 22-23 (July – February) to all
providers. This included provider specific trainings that educated providers on
their responsibilities to patients in their care and client focused trainings
to ensure clients understand their rights as a patient. MHS PRAS is on track to
meet their goals in FY 22-23. For FY 22-23, MHS PRAS has been able to conduct
walkthroughs of all inpatient facilities except for quarter 3. This is due to
inpatient psychiatric units locking down the facility due to a potential COVID
outbreaks. HCA is working with MHS to ensure there is still appropriate
oversight of these facilities when access is not allowed for a walkthrough.
The Contract is a sole source
contract. HCA released a Request for Proposals on BidSync for the subject
services on September 26, 2019, for 32 days. HCA did not receive any responses
from any bidders to the solicitation. HCA Procurement and Contracts contacted
similar service in San Diego County, and they were not interested. MHS was
contacted and was the only organization with an appropriate background in
mental health services that was interested and capable of providing the
requested services. The initial sole source was approved by County Procurement
Office on April 29, 2020.
The MHS is performing
satisfactorily in all other areas of the performance outcome metrics. HCA is
requesting the renewal of this sole source contract. HCA has verified there are
no concerns that must be addressed with respect to Mental Health Systems
ownership/name, litigation status or conflicts with County interests.
The Contract has a subcontractor to
provide legal consultation. See Attachment B for information regarding
subcontractor and Contract Summary Form.
HCA requests the Board approve Amendment
No. 1 with MHS for provision of Behavioral Health Patients' Rights Advocacy
Services, as referenced in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for this Contract
will be included in Budget Control 042 FY 2023-24 Budget and will be included
in the budgeting process for future years.
Funding
Sources:
FED: 4% (including, but not limited
to, Substance Abuse Prevention and Treatment Block Grant; Mental Health Block
Grant).
State: 77% (including, but not
limited to, Mental Health Services Act/Prop 63; Mental Health Realignment;
Tobacco Settlement Revenue).
Fees/Licenses/Other: 18%
(including, but not limited to, Federal Financial Participation).
GF: 1%
The 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 service to clients, if
necessary.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A - Amendment No. 1 for Contract MA-042-20011610 for Provision of Behavioral
Health Patients' Rights Advocacy Services
Attachment B - Contract Summary Form
Attachment C - Welfare and Institutions Code, Sections 5520-5523
Attachment D - Redline Version of Attachment A