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Consent-Health & Human Services # 17.
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| Board of Supervisors |
Adult & Aging |
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| Subject |
| Approve agreement with CommuniCare Health Centers, Inc. to provide health services integrated with behavioral health services for Latino individuals and families in the amount of $611,875 for the period October 1, 2017 through June 30, 2020; and the Sacramento Multiple Advocate Resource Team – Yolo services in the amount of $19,883 for the period October 1, 2017 through January 31, 2018. (No general fund impact) (Larsen) |
| Recommended Action |
- Approve agreement with CommuniCare Health Centers, Inc. to provide integrated health and behavioral health services for Latino individuals and families in the amount of $611,875 for the period October 1, 2017 through June 30, 2020;
- Approve agreement with CommuniCare Health Centers, Inc. to provide the Sacramento Multiple Advocate Resource Team – Yolo (SMART-Y) services in the amount of $19,883 for the period October 1, 2017 through January 31, 2018; and
- Delegate authority to the Director of Health and Human Services Agency and/or her/his designee to sign and execute any additional forms, documents and/or amendments as necessary relating to this agreement as long as no funding increase or significant programmatic changes resulting from approval of any additional forms, documents and/or amendments.
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| Strategic Plan Goal(s) |
Operational Excellence
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
This agreement will provide services for two separate programs as detailed below:
Integrated Behavioral Health Services for the Latino Community & Families
This program will provide culturally appropriate and responsive services to Yolo County Latino residents with health issues, mental health illnesses, and/or substance use problems. This Agreement will serve the Yolo Latino community members as individuals or families. This program will provide a targeted outreach effort to Latino men/heads of household. In addition, this program will develop relationships between consumers of services, support partners, families, various service providers and community. Overall this program will provide integrated health and behavioral health services that will decrease costs to Yolo County as well as to providers of health and behavioral health services for uninsured individuals, reduce mental health hospitalizations and reduce length of stay for Latino individuals in hospitals or residential programs. Successful efforts of this program will improve the quality of life and independence for Latino clients, expand client input on programmatic structure, outreach and treatment activities, and reduce stigma while increasing services in the Latino community.
Sacramento Multiple Advocate Resource Team – Yolo (SMART-Y)
This program is a benefits advocacy project that assists eligible individuals in applying for and receiving federal and state benefits programs, such as Supplemental Security Insurance (SSI), Social Security Disability Income (SSDI), and Medi-Cal. The program prioritizes individuals experiencing homelessness as the highest priority to receive services under this agreement. Approval of this amendment will allow CommuniCare Health Centers, Inc. to continue to provide these services to individuals of all ages who are eligible for federal and state benefits programs.
On August 5, 2014, the Board of Supervisors approved an agreement with CommuniCare Health Centers, Inc. to provide Local Innovation Fast Track (LIFT) services, which the SMART-Y services is a component. The term of the original agreement is July 15, 2014 through June 30, 2015. On June 27, 2017, the Board of Supervisors approved an amendment to extend this agreement through September 30, 2017.
HHSA is now requesting approval of this agreement to include the SMART-Y services to further extend the program through January 31, 2018. This will allow CommuniCare Health Centers, Inc. to continue to provide the SMART-Y services, while HHSA prepares to issue an RFP in November 2017.
The performance measures included in this agreement are as follows:
IBHS for Latino Community & Families
Program
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Agency
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Contact
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Program Purpose
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PEI Stigma and Discrimination Reduction – CCHC Latino Outreach Program: Reduce mental health stigma and hospitalizations and improve quality of life among Yolo County Latino/Hispanic residents. |
Program Information
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This program will provide integrated behavioral health services that decrease the cost to county and providers for uninsured individuals, reduce mental health hospitalizations and length of stay for the target population, improve the quality of life and independence for target population clients, expand the target population’s input on programmatic structure, outreach and treatment activities, and reduce stigma with increased service penetration rates in the Latino community. |
| PM1: How much did we do? |
Staff
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Total FTEs by Classification, including breakdown of program staff who are bilingual and bicultural |
Customers
Units of Service |
Program Participants: Total # of participants served
- Total # of unduplicated participants served
- Total # of participants identified as male heads of household
- Total # of participants who received services in Spanish as their preferred language
Program Activities:
- Total # of FTE Promotores actively involved in the program.
- Total # of unduplicated participants who received a whole-person health screening.
- % of participants screened for a history of trauma.
- Total # of outreach events (minimum weekly).
- Average # of participants at outreach events
- Total # of group counseling “platicas” (minimum bi-weekly).
- Average # of participants at group counseling “platicas”.
- Total # of advisory panel meetings that included representatives from the target population and community-based agencies.
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| PM2: How well did we do it? |
| 2.1 |
Satisfaction[1]: % and # of participants who reported satisfaction with services (e.g., services were provided at a convenient time and location; program staff treated me with respect, respected my cultural background / beliefs, spoke to me in a language that I understood)
Referral/Linkage2
Total # of participants referred to:
- Primary Care services
- Mental Health and / or Substance Use Disorder services
- Other support services (e.g., health benefits enrollment, food resources, housing support)
Total # of participants referred to any service.
Treatment Engagement2: % and # of participants who completed a referral and engaged in treatment. Engagement is defined as participating at least once in the Program to which they were referred, including:
- Primary Care services
- Mental Health and / or Substance Use Disorder services
- Other support services (e.g., health benefits enrollment, food resources, housing support)
Timeliness2: Average interval (in days) between the referral and participation in treatment. Participation is defined as participating at least once in the treatment to which referred.
Duration of Untreated Mental Illness (DUMI) 2: Average DUMI across participants. DUMI is defined as, for persons who are referred to treatment and who have not previously received treatment, the time between the self-reported and/or parent-or-family-reported onset of symptoms of mental illness and entry into treatment. Entry into treatment is defined as participating at least once in treatment to which the person was referred.
Staff Training: % of program staff trained in using evidence informed and evidence based practices3 |
PM3: Is anyone better off? |
| 3.1 |
Stigma4:
- % and # of participants with reduced stigmatizing attitudes, knowledge, and/or behavior related to mental illness and seeking mental health services.
Hospitalizations:
- Reduced % and # of mental health hospitalizations and average length of stay.
Quality of Life:
- % and # of participants with improved functional outcomes (e.g., enrollment in entitlement benefits, employment status, housing status, health insurance coverage, food security)
- % and # of participants with improved mental, physical, and/or emotional well-being outcomes.
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[1] Examples from the California Consumer Perception Survey, available in Spanish (and other languages) at: https://www.cibhs.org/consumer-perception-surveys
2 PEI Regulation Strategy that shall be included in specified PEI Programs (Sections 3735, 3560.010(b))
3 Practices listed in the contract Scope of Work: Motivational Interviewing; Patient Depression Questionnaire (PHQ-9); Protocol to Respond to and Assess Patient Assets, Risks, and Experiences (PRAPARE); Adverse Childhood Experiences (ACES) questionnaire; Screening Brief Intervention, and Referral to Treatment (SBIRT)
4 PEI Regulation reporting requirement specific to Stigma & Discrimination Reduction Programs (Sections 3725, 3750(d))
The PEI Regulations have additional data reporting requirements depending on different program classifications. Not all metrics are incorporated into this form but can be accessed in the Regulation document here: http://mhsoac.ca.gov/document/2016-03/pei-regulations
SMART-Y Program
| Program |
Agency |
Contact |
| Program Purpose |
Achieve timely linkage to social security benefits for the majority of clients served. |
| PM1: How much did we do? |
| 1.1 |
Clients served annually. |
| PM2: How well did we do it? |
| 2.1 |
Percentage of clients who are approved for social security benefits in less than 90 days following application submission. |
PM3: Is anyone better off? |
| 3.1 |
Percentage of clients who are approved for social security benefits following first application with the assistance of the SMART-Y program. |
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| Collaborations (including Board advisory groups and external partner agencies) |
County Counsel has approved this Agreement as to form.
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| Competitive Bid Process |
Competitive Bid Process for the IBHS for Latino Community & Families services:
On April 12, 2017, Yolo County Health and Human Services Agency (HHSA) issued a Request for Proposals (RFP) from qualified community based organizations to provide Latino Outreach/Health/Mental Health workers known as Promotores. This type of worker is a lay Hispanic/Latino community worker with special training in health care and behavioral health care who provides basic health education to Hispanic/Latino individuals and families. In addition, Promotores provide guidance and support in how to access community health resources and serve as Liaisons between their community and community health professionals and organizations. HHSA received one proposal from this solicitation.
The Board of Supervisors recommended the Yolo County Health and Human Service Agency review the RFP process used in this solicitation. After review it was determined this RFP should be re-issued in an effort to ensure the RFP is fair, ethical and competitive, while also maintaining high quality services to Yolo County residents.
On June 21, 2017, HHSA re-issued an RFP desiring to attract qualified community based organizations to provide Integrated Health and Behavioral Health Services for Latino individuals and Families. This second RFP included a revised scope of work; a mandatory Bidder’s Conference; a cover letter with a summary of services, requirements, and timelines; and an option to either submit a proposal through the BidSync process or hand deliver a proposal to HHSA. A notice was also sent out to approximately 60 potential bidders who had previously viewed the original RFP issued on April 12, 2017.
HHSA received two proposals from this solicitation. The proposals were submitted by CommuniCare Health Centers, Inc. and RISE, Inc. Both proposals were evaluated by individuals not affiliated with Yolo County as well as staff from HHSA. This review process determined both proposals met all the required qualifications necessary to successfully provide these services.
Because both proposals met all required qualifications and were of high quality both CommuniCare Health Centers, Inc. and RISE, Inc. will be offered contracts to provide these identified services. A separate agreement with RISE, Inc. will be submitted to the Board for approval.
The Competitive Bid Process below provides a summary of the RFP evaluation criteria.
Request for Proposals (RFP) Service Requested:
Integrated Behavioral Health Services for Latino Community and Families
Evaluation Criteria Included in RFP
- Company overview (20 points)
- Experience and past performance (30 points)
- Responsiveness/Responsibility (10 points)
- Approach to Project (50 points)
- Pricing Requirements (30 points)
- Quality Assurance and Oversight (20 points)
- Outputs and Outcome Measures (40 points)
- Financial Information (pass/fail)
- Quality and Completeness of Proposal (pass/fail)
Bids Received
| Bidder |
Bid |
| CommuniCare Health Centers, Inc. |
$763,526 |
| RISE, Inc. |
$80,547 |
Competitive Bid Process for the SMART-Y services:
On April 21, 2014, HHSA, formerly known as Alcohol, Drug and Mental Health issued an RFP requesting qualified community based organizations to provide MHSA Innovation Services and Programs, including Local Innovation Fast Track (LIFT) services.
HHSA is preparing to issue an RFP for these services in November 2017. |
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
No general funds are required by this action.
The IBHS for Latino Community & Families services will be funded by MHSA PEI funds. The amount of $166,875 is included in the HHSA proposed budget for FY17-18. The related funding will be included in the requested budget process for future fiscal years.
The SMART-Y program services is included in HHSA’s proposal for Housing and Disability Advocacy Program (HDAP) funds. The allocation is expected in Spring 2018. HHSA will utilize IGT funds during the interim period.
The following is the breakdown of funding for this agreement:
Services |
Fiscal Year 2017-18 October 1, 2017
Through
June 30, 2018 |
Fiscal Year 2018-19
July 1, 2018
through
June 30, 2019 |
Fiscal Year 2019-20
July 1, 2019
through
June 30, 2020 |
Total |
| IBHS for Latino Community & Families |
$166,875 |
$222,500 |
$222,500 |
$611,875 |
SMART-Y Program
(for the period October 1, 2017 through January 31, 2018) |
$ 19,883 |
| Total |
$631,758 |
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