REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 25, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendments to Contracts for Foster Family Agency - Mental Health Services Program
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1 to the following contracts, effective January 1, 2024, for the provision of Specialty Mental Health Services with foster family agencies, revising the Statement of Work, updating standard contract language, and increasing the aggregate amount by $10,718,750, from $19,794,525 to $30,513,275, with no change to the contract period:
1. Ark Homes Foster Family Agency, Contract No. 21-931, January 1, 2022 through December 31, 2026.
2. Building Bridges Foster Family Agency, Contract No. 21-932, January 1, 2022 through December 31, 2026.
3. ChildNet Youth and Family Services, Inc., Contract No. 21-933, January 1, 2022 through December 31, 2026.
4. Koinonia Foster Homes, Inc. dba Koinonia Family Services, Contract No. 21-934, January 1, 2022 through December 31, 2026.
5. Seneca Family of Agencies, Contract No. 21-935, January 1, 2022 through December 31, 2026.
6. The Heart Matters Foster Family Agency, Contract No. 21-936, January 1, 2022 through December 31, 2026.
7. Trinity Youth Services, Contract No. 21-937, January 1, 2022 through December 31, 2026.
8. Walden Environment dba Walden Family Services, Contract No. 21-938, January 1 2022, through December 31, 2026.
9. Greater Hope Foundation for Children, Contract No. 22-676, July 12, 2022 through December 31, 2026.
10. Nuevo Amanecer Latino Children’s Services, Contract No. 22-677, July 12, 2022 through December 31, 2026.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The recommended combined increase of $10,718,750, from $19,794,525 to $30,513,275, for the Foster Family Agency (FFA) - Mental Health Services (MHS) program is funded by Federal Financial Participation Medi-Cal funds, 2011 Realignment funds, and revenue pursuant to a Memorandum of Understanding with the Department of Children and Family Services (CFS). Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. The FFA-MHS program provides specialty mental health services (SMHS) which is a comprehensive mental health service program for Medi-Cal beneficiaries under the age of 21 who have full scope Medi-Cal eligibility. The FFA-MHS program provides services to youth who are dependents or wards of the court and referred to the FFA for residential services. DBH has contracted with Foster Family Agencies for the provision of SMHS since 2016 and added the provision of Therapeutic Foster Care services in 2019.
On December 14, 2021 (Item No. 22), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 21-931 with Ark Homes Foster Family Agency, Contract No. 21-932 with Building Bridges Foster Family Agency, Contract No. 21-933 with ChildNet Youth and Family Services, Inc., Contract No. 21-934 with Koinonia Family Services, Contract No. 21-935 with Seneca Family of Agencies, Contract No. 21-936 with The Heart Matters Foster Family Agency, Contract No. 21-937 with Trinity Youth Services, and Contract No. 21-938 with Walden Family Services for the provision of Foster Family Agency - Mental Health Services Program, in the combined aggregate amount of $19,794,525, for the period of January 1, 2022 through December 31, 2026.
On July 12, 2022 (Item No. 14), as the result of a formal procurement, the Board approved Contract No. 22-676 with Greater Hope Foundation for Children and Contract No. 22-677 with Nuevo Amanecer Latino Children’s Services for the provision of Foster Family Agency - Mental Health Services Program, with no change in the combined aggregate amount of $19,794,525, for the period July 12, 2022, through December 31, 2026.
On July 16, 2021, Assembly Bill (AB) 153 made funding available to Child Welfare Agencies to expand the residential options for high need foster youth who require intensive Early and Periodic Screening Diagnostic and Treatment (EPSDT) SMHS. AB153 provides funding to support children and youth, and their families in order for them to be successful in their community and in the least restrictive setting. This funding allows for the advocacy for an individualized package of supports and services that meet the complex needs of young people, as well as to build the County’s capacity to provide community-based support long term. In addition, AB 153 mandates the creation of the Children’s Crisis Continuum Pilot (CCCP). The CCCP provides a framework for a highly integrated continuum of care for foster youth with high acuity needs.
In March of 2022, CFS submitted a proposal to the state and was awarded Complex Care Capacity Building (CCCB) funding for:
1. 10 Enhanced Intensive Foster Care (E-ISFC) homes for high needs foster youth who are Commercially Sexually Exploited Children (CSEC).
2. 10 Intensive Services Foster Care (ISFC) for high needs foster youth.
CFS released requests for proposal (RFP) for both E-ISFC and ISFC homes. To date, CFS has been able to contract with one provider, The Heart Matters Foster Family Agency (The Heart Matters), for five ISFC homes; CFS will be releasing an RFP for five additional ISFC homes and 10 Enhanced ISFC homes.
In addition, on December 1, 2022, Riverside County CFS as the lead agency, in coordination with San Bernardino County CFS, submitted a joint CCCP proposal in the amount of $10,000,000 to the California Department of Social Services. Riverside County CFS will receive the funds and will transfer San Bernardino County CFS’s portion through an MOU between the two agencies to be completed at a later date. The funding will be used by multiple programs to implement CCCP. One critical program is the availability of E-ISFC and ISFC placements and services. The two-county effort to implement CCCP is known at the Inland Empire Collaborative.
Both the E-ISFC and ISFC homes are for high needs foster youth and are tailored to the individualized needs of the foster youth with coordination/collaboration of services between providers and the Resource Parent (RP). The RP, also referred to as a Professional Parent, is specially trained to provide a higher level of care and support to foster youth in their care including providing intensive EPSDT SMHS via Therapeutic Foster Care services. In addition to the SMHS, the homes require a weekly Child and Family Team Meeting and daily SMHS. DBH anticipates approximately 10 youth will be served in an ISFC home annually during this contract at an estimated cost of $300,000 per youth ($25,000 per month) and 2-3 youths will be served annually in an E-ISFC and/or an ISFC home at an estimated cost of 215,000 per youth ($17,916 per month).
This item is being presented at this time due to extended DBH program, fiscal, administrative and legal reviews. In addition, The Heart Matters (a foster family agency listed in the Recommendation) has been providing ISFC services to DBH children and youth at three facilities since January 1, 2024; retroactive approval is needed to compensate The Heart Matters for services provided. Approval of this item at this time will not impact DBH operations.
Approval of the amendments to the contracts identified in the recommendation will update standard contract language by adding Executive Order N-6-22 - Russia Sanctions, Campaign Contribution Disclosure (Senate Bill 1439).
DBH will also implement mechanisms to regularly 1) review client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) review applicable reimbursement claims and claims data to ensure fidelity and accuracy of service billing an optimization of Medi-Cal reimbursement in alignment with Contract terms and Department of Health Care Services billing requirements; and 3) review provider invoices administratively and programmatically to ensure client count and services are accurate prior to payment processing.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by (Ellayna Hoatson, Contracts Supervisor, 388-0858) on June 10, 2024; County Counsel (Charles Phan, Supervising Deputy Counsel, 387-5455) on June 13, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on June 13, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on June 13, 2024.