Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  23-000593

 

MEETING DATE:

09/26/23

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):

Veronica Kelley (714) 834-7024 

 

 

Adil Siddiqui (714) 834-6619

 

 

Subject:  Amendment for Behavioral Health Digital Solutions Services

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: Yes

Current Year Cost:   $10,695,000

Annual Cost: N/A

 

 

 

    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:         8/9/2022 #16, 4/27/2021 #23, 1/14/2020 #25, 4/9/2019 #10

 

RECOMMENDED ACTION(S):

 

 

1.

Approve Amendment No. 3 to Contract with Chorus Innovations, Inc. for Behavioral Health Digital Solutions Services, increasing the not to exceed amount by $10,695,000, for the term of September 26, 2023, through June 30, 2024, for a revised cumulative contract total amount not to exceed $27,920,000, renewable for two additional one-year terms.

 

 

2.

Authorize the County Procurement Officer or Deputized designee to execute Amendment No. 3 to Contract with Chorus Innovations, Inc. as referenced in the Recommended Action above.

 

 

 

 

SUMMARY:

 

Approval to execute Amendment No. 3 to amend the Contract with Chorus Innovations, Inc. will expand the development and refinement of a suite of integrated digital health solutions which, collectively, will improve access to and quality of client care, optimize workforce capacity and increase data integrity for Mental Health and Recovery Services within the Health Care Agency.

 

 


 

 

BACKGROUND INFORMATION:

 

On April 27, 2021, your Honorable Board of Supervisors (Board) approved the Contract with Chorus Innovations, Inc. (Chorus) for provision of Behavioral Health Digital Solutions Services (formerly Behavioral Health System Transformation OC Navigator Services). Below are additional Board actions that were executed pursuant to appropriate authorities.  

 

Board Date

Contract/Amendment

Action

Term

April 9, 2019

Proposal

Board approved Innovation Proposal

May 24, 2019 -

May 23, 2021 

January 14, 2020

Participation Agreement

Board approved Participation Agreement

January 21, 2020 -

June 30, 2022

April 27, 2021

Contract

Board approved Contract

June 01, 2021 -

June 30, 2024

 May 17, 2022

Amendment No. 1

Deputy Purchasing Agent Authority - Contingency Contract Increase

June 01, 2021 -

June 30, 2024

August 9, 2022

Amendment No. 2

Board Approved Amendment

June 09, 2022 -

June 30, 2024

 

During this contract period, Chorus has continued to partner closely with community members and Mental Health and Recovery Services (MHRS) programs to develop, expand and refine the features and functionality of the OC Navigator, a curated digital resource navigation tool available in multiple languages to the public and providers for identifying behavioral health and supportive services. Chorus has transitioned several MHRS county and county-contracted programs, including OC Links, mobile Crisis Assessment Teams, Crisis Stabilization Units, OC WarmLine and OC Outreach and Engagement, onto the platform to improve program operations and efficiency (i.e., reduction of duplicate data entry, use of paper forms, repeated faxing or emailing of forms, etc.). In addition, Chorus is actively working on transitioning the MHRS Crisis Residential Programs and Inpatient Psychiatric Hospitalization Treatment Authorization Requests onto the platform and is gathering workflow and technical requirements to transition the MHRS Substance Use Disorder (SUD) Residential Treatment facilities. Each solution is designed to allow visibility into current case or referral status and to facilitate timely access to care for clients accessing these programs’ services.

 

As this work has progressed, public behavioral health systems have faced several recent and emerging State and Federal mandates related to mobile crisis response, 988, California Advancing and Innovating Medi-Cal (CalAIM), Community Assistance, Recovery and Empowerment (CARE) Act, Behavioral Health Services Act modernization and others. This has resulted in new requirements and/or extensive changes to existing requirements that affect data collection and reporting, as well as service delivery and billing. In addition, the California Department of Health Care Services’ External Quality Review Organization has consistently issued audit findings to Orange County regarding limitations with its information systems and data handling for the Mental Health Plan and Drug Medi-Cal Organized Delivery System. Thus, MHRS must rapidly enhance its technical capabilities to be able to respond to these simultaneous reforms, mandates and audit findings to avoid revenue loss and/or potential sanctions.

           

The proposed Amendment will expand currently incorporated programs and includes a variety of enhancements needed to improve overall functionality and reporting, as outlined below:

 

 

 

 

 

 

Enhancements to improve the searchability, content and/or organization of resources in two solutions: OC Navigator, Multi-Language Support

 

Enhancements to existing programmatic and incoming referral workflows in four existing solutions: OC Links, Mobile Crisis Assessment Team, Crisis Stabilization Units, OC Outreach & Engagement

 

Three new customized solutions for crisis programs: Crisis Residential, In-Home Crisis Stabilization, Treatment Authorization Request for Psychiatric Hospitalizations

 

Integration of data collection and program workflows required to support CARE Act implementation

 

Initial development of a comprehensive, secure Closed-Loop Referrals and Linkages system that facilitates MHRS providers’ ability to successfully refer and link clients across the entire MHRS system of care (i.e., Mental Health, SUD, Crisis, Forensics, etc.)

 

 

Collectively, the proposed work will increase the efficiency and quality of behavioral health services by automating manual, repetitive and often time-consuming tasks, reducing duplicate data entry and improving data integrity while ensuring strict privacy and security standards are maintained.

 

The proposed Amendment is a sole source Contract. Development of the OC Navigator initially began in 2020 through a Participation Agreement with the fiscal intermediary, CalMHSA. At that time, Chorus was the only vendor qualified through CalMHSA’s Request for Statement of Qualifications (RFSQ) with the capacity to build the suite of proposed features for the OC Navigator. HCA did additional research to identify other vendors that had not responded to CalMHSA’s RFSQ, and the one identified vendor declined to submit a proposal for customizing their platform to incorporate OC Navigator features. At present, Chorus is the only vendor that can continue the existing contract deliverables and execute the expanded scope of work in a cost efficient and timely process with minimal to no risk to behavioral health consumers because the platform is already hosting custom-built digital solutions for several 24/7 crisis programs: OC Links, mobile Crisis Assessment Teams and all four CSU sites. Chorus has extensive knowledge of the inner workings of HCA Programs and workflows, security clearance from HCA IT to handle protected health information, and a host platform that supports the daily operations of multiple HCA programs. Orange County Information Technology is in concurrence with this Contract.

 

This Contract does not currently include subcontractors or pass through to other providers. See Attachment B for Contract Summary Form. The Orange County Preference Policy is not applicable to the proposed Amendment. This Contract contains non-standard County contract language. Risk Management has reviewed and approved the language regarding Limitation of Liability and Indemnification. The completed and approved Risk Assessment Form is attached as Attachment C.

 

The Contractor's performance has been confirmed as at least 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.

HCA requests that the Board authorize the County Procurement Officer or Deputized designee to execute Amendment No. 3 to the Contract with Chorus Innovations, Inc. as referenced in the Recommended Actions.

 

 

 

FINANCIAL IMPACT:

 

Appropriations for this Contract are included in Budget Control 042 FY 2023-24 Budget. 

 

Funding Source:

 

100% State: (CARE Court Start-up Funds, Mental Health Services Act/Prop 63, Crisis Care Mobile Unit Grant).

 

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 - Amendment No. 3 to Contract No. MA-042-21011323
Attachment B - Contract Summary Form
Attachment C - Risk Assessment Form
Attachment D - Redline Version to Attachment A