Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  22-000955

 

MEETING DATE:

05/23/23

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 

 

 

Veronica Kelley (714) 834-7024

 

 

Subject:  Renewal of Contract for Behavioral Health Patients' Rights Advocacy

 

      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 2023-24 $1,433,515
FY 2024-25 $1,462,085

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   Yes

    Current Fiscal Year Revenue: N/A

   Funding Source:     See Financial Impact Section

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         5/19/2020 #19

 

RECOMMENDED ACTION(S):

 

 

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.

 

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.

 

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:

 

 

FY 21-22 actuals

FY 22-23 actuals (July through February)

 

A minimum of 1,800 contacts per fiscal year

21,025

17,780

At minimum, two onsite visits a week with inpatient facilities to ensure compliance with patients’ rights regulations

4

4

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