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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings that the provision of school and community-based therapy to eligible youth provided by Contractor are in the public's best interest and that there are specialty skills, qualifications, and equipment not expressly identified in County classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(B), El Dorado County Charter, Section 210(b)(6), and/or Government Code Section 31000;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(2f) exempting the competitive bidding process, with Purchasing Agent concurrence, because “the procurement is for goods where the continuity of providers will provide efficiency or critical knowledge, and other providers of the goods cannot provide similar efficiencies or critical knowledge”;
3) Approve and authorize the Chair to sign Agreement for Services 6989 with Sierra Child and Family Services, Inc., with a not-to-exceed amount of $650,000, for the retroactive term of two years from July 1, 2022 through June 30, 2024; and
4) Authorize the HHSA Director, or the Behavioral Health Director, to execute further documents relating to Agreement for Services 6989, contingent upon approval by County Counsel and Risk Management, including amendments which do not increase the maximum dollar amount or term of the Agreement.
FUNDING: 100% Federal Mental Health Services Block Grant.
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DISCUSSION / BACKGROUND:
The Health and Human Services Agency (HHSA) is a recipient of Community Mental Health Services Block Grant (MHBG) funds via the Substance Abuse and Mental Health Services Agency (SAMHSA) and the Department of Health Care Services (DHCS). MHBG funds must be spent in accordance with Public Law (PL) 102-321 (Block Grants to States Regarding Mental Health & Substance Abuse) and PL 106-310 (Children’s Health Act of 2000). The HHSA MHBG award for Fiscal Year (FY) 2022-23 and 2023-24 is $437,347 for each year, for a total award of $874,694.
Since FY 2014-15, HHSA has dedicated MHBG funding to provide Dialectical Behavior Therapy (DBT) and Transitional Age Youth First Episode Psychosis (FEP) services in El Dorado County high schools. DBT is an evidence-based psychotherapy approach used to treat many conditions, based on mindfulness skills, distress tolerance skills, and emotional regulation. FEP refers to the initial symptoms of psychosis, and when a client is connected quickly with the right treatment services, the services can be life-changing and can radically alter the person’s future.
In December 2019, HHSA processed a Request for Proposal (RFP) 20-918-029 for DBT and Transitional Age Youth FEP services on the West Slope of El Dorado County (County), which resulted in a single proposal from Sierra Child and Family Services, Inc. (SCFS). As a result, SCFS was awarded the RFP by the County Board of Supervisors (Board), and Agreement 4342 was executed with SCFS for a one-year term (File ID 19-1461) to coincide with the MHBG FY funding HHSA was awarded. Thereafter, Agreements 5012 and 5417 were approved by the Board and executed with SCFS, each for one-year terms to coincide with the MHBG FY funding awarded to HHSA (File ID: 20-0908 and 21-0002).
The success of the SCFS DBT and FEP programs on high school campuses has been supported by collaboration between SCFS and El Dorado County area schools, resulting in dedicated space in the high schools to conduct mental health screenings and services to ensure easy access for eligible children and youth.
In late May 2022, HHSA received the request for application from DHCS for FY 2022 through 2024 MHBG funding and submitted its application on June 2, 2022. The funding was awarded to HHSA on August 8, 2022, and was accepted by the HHSA Director per Board delegation provided via Resolution 093-2022 (File ID: 22-0813). In the interim, SCFC’s Agreement 5417 expired on June 30, 2022, the end date of the FY 2021-22 MHBG funding. Having already established space in the high schools to provide the services and recognizing the importance of the provision of the services to the youth in the community, SCFS continued to provide the DBT and FEP services, and is still providing the services today.
Additionally, on July 29, 2022, a contract request was formally submitted to the HHSA Contracts Unit in anticipation of the award, however, although the funding source has been consistently received, County staff would not finalize the contract until funding was confirmed. Heavy workloads, County technological transitions, and staff scheduling delayed the execution of the Agreement. However, as previously stated, recognizing the importance of the provision of the services to the youth in the community, SCFS continued to provide the DBT and FEP services. Therefore, HHSA requests the Board approve Agreement for Services 6989 with SCFS for a retroactive term of July 1, 2022, through June 30, 2024, to coincide with the end date of the FY 2022-24 MHBG funding.
Lastly, under Board Procurement Policy C-17 Section 3.4, effective October 20, 2022, HHSA recommends exempting the competitive bidding process, with Purchasing Agent concurrence, because (2f) “the procurement is for goods where the continuity of providers will provide efficiency or critical knowledge, and other providers of the goods cannot provide similar efficiencies or critical knowledge.” The potential effects to youth currently receiving DBT and FEP services being unable to continue said services, and the potential effects to youth not having access to said services, outweighs any benefits from beginning the competitive solicitation process. Competitive solicitation will be engaged prior to the expiration date of Agreement 6989 to maintain continuity of operations.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA will be out-of-compliance with the FY 2022-24 MHBG plan and application, which indicates that the services will be contracted out due to the specialized skills needed to provide said services.
PRIOR BOARD ACTION:
1) 01/14/20, File ID 19-1461 HHSA DBT & FEP RFP Award to Sierra Child & Family Services Agreement 4342
2) 09/01/20, File ID 20-0908 - HHSA Sierra Child & Family Services Agreement 5012
3) 06/29/21, File ID 21-0002, HHSA Sierra Child & Family Services Agreement 5417
4) 06/21/22, File ID 22-0813, HHSA Behavioral Health Director Signing Authority Resolution 093-2022 for PATH and MHBG grants
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management. The Auditor-Controller was notified per Board Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund cost associated with this Agenda item. This agreement will be funded with MHBG funding. Sufficient appropriations were included in the FY 2022-23 Budget and will be included in future budget requests for the remainder of the agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one (1) original Agreement for Services 6989.
STRATEGIC PLAN COMPONENT:
Healthy Families
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services Agency