REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 27, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contracts for 0-5 Comprehensive Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve amendments to the following contracts for the provision of 0-5 Comprehensive Treatment Services, increasing the amount by $24,289,113 from $104,499,930 to $128,789,043, and extending one year, for a total contract period of July 1, 2018 through June 30, 2024:
1. Citrus Counseling Services, Inc., Amendment No. 2 to Contract No. 18-344, increasing the total contract amount by $2,576,579, from $10,735,975 to $13,312,554.
2. Desert/Mountain Children’s Center, Amendment No. 2 to Contract No. 18-345, increasing the total contract amount by $10,357,477, from $46,450,200 to $56,807,677.
3. Hearts & Lives, Amendment No. 1 to Contract No. 18-346, increasing the total contract amount by $598,319, from $2,493,050 to $3,091,369.
4. Lutheran Social Services of Southern California, Amendment No. 2 to Contract No. 18-347, increasing the total contract amount by $997,198, from $4,155,080 to $5,152,278.
5. Victor Community Support Services, Inc., Amendment No. 1 to Contract No. 18-348, increasing the total contract amount by $5,998,844, from $24,995,720 to $30,994,564.
6. West End Family Counseling Services, Amendment No. 1 to Contract No. 18-349, increasing the total contract amount by $3,760,696, from $15,669,905 to $19,430,601.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Ensure Development of a Well-Planned, Balanced, and Sustainable County.
Provide for the Safety, Health, and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The increase of $24,289,113 for 0-5 Comprehensive Treatment services is funded by the Children and Families Commission for San Bernardino County (First 5), Mental Health Services Act Prevention and Early Intervention, Federal Financial Participation Medi-Cal, 2011 Realignment, and matching funds from Desert Mountain Special Education Local Planning Area (DMSELPA), up to $522,169. Adequate appropriation and revenue have been included in the Department of Behavioral Health (DBH) 2022-23 and 2023-24 budgets.
BACKGROUND INFORMATION
DBH is responsible for providing behavioral health and substance use disorder services to San Bernardino County (County) residents experiencing severe and persistent mental illness, substance use, and other addictions. An integral part of the service delivery system consists of County-operated clinics and contracted service providers delivering a variety of mental health treatment services, including 0-5 Comprehensive Treatment Services (0-5 CTS). 0-5 CTS is a Mental Health Services Act - Prevention and Early Intervention program administered through the DBH Children and Youth Connection Services unit. The program includes 0-5 CTS, which is comprised of two programs: Screening, Assessment, Referral, and Treatment (SART) and Early Identification and Intervention Services (EIIS). Services are provided countywide.
The SART program is designed to improve social, developmental, cognitive, emotional, and behavioral functioning to children ages 0-5. These children have been diagnosed with mental health disorders that require specialty mental health services (SMHS). Children referred to SART have experienced abuse (e.g., physical, sexual, or emotional), neo-natal issues (e.g., premature birth, poor maternal nutrition, or prenatal exposure to alcohol or other drugs), family issues (e.g., family violence, family substance use disorders, maternal mental illness), or been involved in the foster care system. For children who begin SART services before their fifth birthday, services may continue until their sixth birthday.
The EIIS program provides services to children ages 0-9 who struggle with social-emotional disturbances or display developmental concerns that require less intensive, short-term interventions. Services focus on children identified as unserved, underserved, or who have been referred from SART or the universal screening process.
DMSELPA, a support services office that serves as a liaison to the desert and mountain local school districts, has a history of partnership with Desert/Mountain Children’s Center (DMCC) to provide Early & Periodic Screening, Diagnosis & Treatment (EPSDT) Medi-Cal SMHS to eligible children and youth in the school environment in the Low Desert, High Desert and Mountain regions. EPSDT benefits provide comprehensive and preventive health care services for children under age 21. DMSELPA will provide a non-federal match for a portion of the costs for EPSDT Medi-Cal SMHS to eligible children and/or youth through DBH contracts with DMCC, up to $552,169, which will allow for an additional $3,952,534 of Medi-Cal funded services to children and youth served by DMCC. This additional funding is included in the contract award to DMCC.
DBH anticipates that the recommended agencies will provide services to approximately 2,500 children in 2023-24 through SART at an estimated cost of $6,280 per client, and approximately 1,500 children through EIIS, at an estimated cost of $5,726 per client.
PROCUREMENT
On June 12, 2018 (Item No.35), as the result of a formal procurement, the Board of Supervisors (Board) approved the contracts in the Recommendation for the provision of 0-5 CTS, in the amount of $104,499,930 for the period of July 1, 2018 through June 30, 2023.
On June 8, 2021 (Item No. 33), the Board approved a standardized contract template to amend contracts with providers for the provision of SMHS to remove the County Contract Rate Provisions, effective March 1, 2020, and authorized the DBH Director to execute these amendments.
On September 10, 2021, the DBH Director, as authorized by the Board, executed Amendment No. 1 to Contract No. 18-345 with DMCC and Contract No. 18-347 with Lutheran Social Services (LSS), removing the County Contract Rate provisions via the standardized contract template amendment.
On September 20, 2021, the DBH Director, as authorized by the Board, executed Amendment No. 1 to Contract No. 18-344 with Citrus Counseling Services, Inc. (CCS), removing the County Contract Rate provisions via the standardized contract template amendment.
DBH is recommending extending the contracts with CCS, DMCC, Hearts & Lives, LSS, Victor Community Support Services, Inc. and West End Family Counseling Services for an additional year. An additional year is being requested due to the time necessary to review changes from the Department of Health Care Services, tasking DBH with developing new methods of increasing an existing service requirement through implementation of the Integrated Care Practice Model, including the provision of Intensive Care Coordination and Intensive Home-Based Services. A new procurement for the provision of 0-5 Comprehensive Treatment Services will be conducted and concluded in 2023-24 for service effective July 1, 2024.
DBH will continue to monitor contract performance on a regular basis to ensure performance and compliance standards are met by reviewing monthly reports, ongoing site visits to review consumer progress, as well as an annual program review. The provider invoices will be reviewed by Fiscal staff for payment. Fiscal staff will verify signatures and services costs prior to issuing payment.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on May 17, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on June 1, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on June 5, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on June 8, 2023.