Approve second amendment to Agreement No. 23-161 with Victor Community Support Services to add funding in the amount of $172,275 for 2023-24 for a new contract maximum of $915,775, for the period of July 1, 2023 through June 30, 2024 for the provision of children’s outpatient intensive mental health services in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative. (No general fund impact) (Sullivan)

Approve second amendment to Agreement No. 23-161 with Victor Community Support Services to add funding in the amount of $172,275 for 2023-24 for a new contract maximum of $915,775, for the period of July 1, 2023 through June 30, 2024 for the provision of children’s outpatient intensive mental health services in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative.

Process section, below, to solicit a provider for children’s outpatient mental health treatment services, including intensive outpatient mental health services (“Intensive Services”.) Intensive Services are focused home and community-based services targeting children and youth under the age of 21 with high levels of need. One aspect of Intensive Services program is the provision of services through a Wraparound Program (Wraparound Program.)  The Wraparound Program provides tailored community-based intervention services to meet the needs to families with children under the age of 21 who are either wards, dependents, or at risk of placement in a congregate care facility. Some of services provided via the Wraparound Program are eligible services under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit to Medi-Cal eligible children and adolescents in our community.

The resulting agreement was awarded to Victor Community Support Services and on November 6, 2018, the County and Victor Community Support Services entered into Agreement No. 18-243, which provided an initial term of September 1, 2018 through June 30, 2019, with four optional extensions for FY’s 2019-20 ($743,500), 2020-21 ($743,500), 2021-22 ($743,500) and 2022-23 ($743,500). The County has exercised all the available optional extensions under Agreement No. 18-243.

California Advancing and Innovating Medi-Cal (CalAIM) Initiative
In January 2022, California Department of Health Care Services (DHCS) rolled out the CalAIM initiative that aims to provide broad delivery system program and payment reform across the Medi-Cal system. The goal is transformation of the Medi-Cal delivery system, moving it towards a population health approach that prioritizes prevention and whole person care. Focus shifts from compliance to quality and performance metrics. Specialty Mental Health Services (SMHS) requirements and policies pursuant to the CalAIM initiative were updated, and as a result of these updates, the County is required to revise the terms and conditions in the provider agreements for these services.  In preparation for this system wide change, the County has been working closely with CalMHSA who has been providing the County and other SMHS Medi-Cal counties with technical assistance around the CalAIM initiative.

On or about June 27, 2023, the County and Victor Community Support Services entered into a one-year renewal agreement for the provision of children’s outpatient intensive mental health services in an amount not-to-exceed $560,675 for the period of July 1, 2023 through June 30, 2024.

On or about October 10, 2023, the County amended the Agreement to add CWS-WRAP funding in the amount of $182,825 for FY 2023-24 for a new contract maximum of $743,500.

HHSA requests approval of this second amendment which adds additional Medi-Cal funding in the amount of $172,275 for FY 2023-24.

Performance Measures

The Performance Measures were included in the underlying Agreement and are not being revised at this time.

This Agreement stared on July 1, 2023, so their performance measure data available thus far indicates Victor Community Support Services has performed satisfactorily under this Agreement. Victor Community Support Services also performed satisfactorily over the prior contracted period term (2018-2023).

County Counsel has approved the Amendment as to form
General Services Department, Procurement Division

On April 2, 2018, the County issued a competitive solicitation via request for proposals (RFP) from qualified community-based organizations to provide Children’s Outpatient Mental Health Treatment Services, including Community Based EPSDT services (formerly known as “Primary Services”) and Intensive Services.  Community Based EPSDT services are designed to serve the largest group of eligible children and youth, targeting Medi-Cal beneficiaries. These services are provided in the community and sometimes in the office.  Referrals to Community Based EPSDT services are the most common initial referral made for a child or youth.  Intensive Services include Therapeutic Behavioral Services (TBS); Children’s MHSA-FSP Services; and the Wraparound Program. Intensive Services target children and youth under the age of 21 with high levels of need with the provision of intensive home and community-based programs. Intensive Services may include all of the services provided under Community Based EPSDT Services.

The RFP was open for 46 days (just over 6 weeks).  On April 12, 2018, potential bidders were offered an opportunity to ask questions during a Mandatory Bidders’ Conference on April 19, 2018, additional questions concerning the RFP could be asked via the Bidsync website. The County received six proposal(s) from this solicitation.

A six-person Proposal Review Committee was formed that included 3 HHSA employees, from 2 different HHSA branches, as well as 3 other reviewers. The Review Committee evaluated the proposals and determined that the proposal submitted by Victor Community Support Services, Inc. met all the required qualifications necessary to successfully provide these services. 

The proposals from Heritage Oaks and NAMHS were not awarded a contract.

A formal solicitation for these services was released mid-year FY 2023-24, a new contract will be issued for FY 2024-25.

No general funds are required by this action. These services will be funded by Medi-Cal Federal Financial Participation (FFP) and Mental Health (MH) Realignment; the additional funding will be funded by Child Welfare Services-WRAP funding. The action increases the contract maximum by $172,275 for a total of $915,775 for the period of July 1, 2023 through June 30, 2024. The amount of $172,275 is included in the HHSA adopted budget fiscal year 2023-24.