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Health and Human Services Agency (HHSA) recommending the Board:
1) Approve and authorize the Chair to sign a Fiscal Year (FY) 2024-25 Budget Transfer Request to increase State revenue and appropriations of Fixed Assets for two mobile crisis care vans in the amount of $500,000, for the HHSA Behavioral Health Division (BHD) (4/5 vote required);
2) Add two mobile crisis care vans to the FY 2024-25 Fixed Asset list in the total amount of $500,0000;
3) Waive formal bid requirements in accordance with Purchasing Policy C-17 Section 3.4, Exemptions from Competitive Bidding, due to a competitively bid Purchase Order (PO) being utilized for the acquisition of two mobile crisis care vans being purchased for HHSA;
4) Authorize the use of Siskiyou County (Siskiyou) Request for Proposals BHS 24-02 and the competitively bid PO 2400256 between Siskiyou and Avan Mobility Inc (Avan) for the acquisition of two 2024 RAM 2500 Promaster Cargo Vans (contingent upon inventory at time of purchase) to serve as mobile crisis care vans in El Dorado County; and
5) Authorize the Purchasing Agent to issue a PO to Avan, for the amount of $387,789.97, as shown by the attached Quote labeled A - Proposal P113368, plus any applicable delivery, licensing, registration fees, and taxes, for the purchase of two Ford Transit All Wheel Drive Cargo Vans priced at $193,894.99 each.
FUNDING: 100% State Behavioral Health Continuum Infrastructure Round 1 Grant Funding for Crisis Care Mobile Units.
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DISCUSSION / BACKGROUND:
In early 2021, California Department of Health Care Services (DHCS) developed the CCMU grant program to support and expand behavioral health mobile crisis and non-crisis services throughout the State. DHCS contracted with Advocates for Human Potential, Inc. (AHP) to be the Administrative Entity of the CCMU awarded grant agreements. On October 11, 2021, HHSA’s BHD applied to the CCMU grant.
In February 2022, AHP notified BHD that their application had been selected for an initial $200,000 planning grant, which was accepted by the Board on June 14, 2022, with Funding-In Agreement 6256, for the development of an Action Plan (AP) that addresses the need of mobile crisis and non-crisis outreach programs in the County (Legistar file 21-1989). Subsequently, BHD developed an AP which would provide mobile behavioral health crisis services throughout the County and submitted the finalized AP to DHCS/AHP. This AP included the purchase of two outreach vehicles with customized safety equipment built to enhanced specifications, estimated to be $461,960 each, for a total of $923,920, for use by HHSA to perform Mobile Outreach Services throughout the County.
On December 8, 2022, DHCS/AHP awarded HHSA BHD an additional $2,000,000 for CCMU Early Implementation and Base Allocation Funding, to be processed via a Modification to the existing Funding-In Agreement 6256. Thereafter, on May 2, 2023, the Board approved Modification 2 to this Agreement, accepting an additional $2,000,000 in CCMU operation funds, increasing the total award of the grant to $2,200,000, and extending the term through June 30, 2025 (Legistar file 23-0066). This modification provided HHSA BHD the opportunity to purchase numerous resources, including the mobile outreach vehicles deemed necessary for the successful implementation of the County’s 24/7 Mobile Crisis Services AP submitted to DHCS.
These vehicles were initially expected to be received and paid for by December 31, 2023, as outlined in the Plan’s deliverables. Vendors identified with the capability to meet the enhanced vehicle specifications projected a delivery date well beyond December 31, 2023. While efforts were made to develop a strategy for use of these funds within the DHCS/HHSA parameters prior to the expenditure timeline, by late 2023 it was deemed unrealistic as HHSA could not identify a vendor that could meet the vehicle specifications within the desired timeline. Consequently, HHSA sought approval from the DHCS to extend the expenditure deadline for the CCMU funding to allow HHSA more time to procure the vehicles.
On April 25, 2024, HHSA BHD was notified by DHCS that an extended deadline of June 30, 2024, was confirmed for the use of funds to purchase the vehicles to be used by county Mobile Crisis teams. On May 13, 2024, DHCS extended the deadline once again to November 1, 2024, and most recently to December 31, 2024. Concurrently, HHSA identified that Siskiyou had recently conducted RFP BHS 24-02 to competitively solicit a vendor to provide customized Mobile Crisis Response Vehicles. As a result of that RFP, Siskiyou awarded Avan’s proposal and issued PO 2400256 for the purchase of two 2023 Ram 3500 Promaster Cargo 159" vans, with the awarding bid providing the same specifications that HHSA BHD was seeking. HHSA BHD quickly identified that Avan has the proper inventory to fulfill HHSA’s desired purchase for comparable vans and confirmed this vendor can meet the rapid deadline and is willing to work within County processes. These two cargo vans are to be used by HHSA BHD staff to provide mobile crisis services on both slopes of the County and will meet the deliverables laid out in the division’s DHCS-approved CCMU Action Plan.
HHSA is requesting the Board authorize and approve the issuance of a piggyback PO for the purchase of two 2024 RAM 2500 Promaster Cargo vans that are customized for the performance of Mobile Crisis Outreach services throughout El Dorado County. HHSA BHD’s Mobile Crisis Outreach services will include the provision of rapid response, individual assessment, and community-based stabilization to individuals within the County who are experiencing a mental health and/or substance use disorder (SUD) crisis. Mobile Crisis services are designed to provide relief to individuals experiencing a behavioral health crisis event through de-escalation and stabilization techniques; reduction of immediate risk of danger and subsequent harm; and avoidance of unnecessary emergency department care, psychiatric inpatient hospitalizations, and law enforcement involvement.
In accordance with Board of Supervisors Procurement Policy C-17 Section 3.4 (4), the department is requesting the Board exempt this purchase from competitive bidding, due to the use of competitively bid piggyback purchase order awarded by Siskiyou to Avan for comparable vehicle specifications and purchase price.
ALTERNATIVES:
Should the Board decline to approve this recommendation HHSA BHD would be unable to use approximately $500,000 in grant funding that would otherwise be expensed to other limited funding sources such as Mental Health Services Act, Realignment or County General Fund that are utilized for the provision of services throughout the community.
PRIOR BOARD ACTION:
1) 06/14/22, 21-1989, HHSA Advocates for Human Potential, 6256
2) 05/02/23, 23-0066, HHSA Advocates for Human Potential, 6256 amendment
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel. Procurement and Contracts.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item. HHSA is requesting a budget transfer of $500,000 for the Fixed Asset purchase to ensure sufficient appropriations in the FY 2024-25 Budget related to the Federal Crisis Care Mobile Unit Grant Funding. Ongoing maintenance and repairs will be paid by MHSA Community-based Outreach and Linkage Project or other applicable project in future MHSA Plans or updates.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on attached Budget Transfer Request.
2) Clerk of the Board to submit signed Budget Transfer Request to the Chief Administrative Office for processing.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency