Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings in accordance with County Ordinance 3.13.030 that it is appropriate to contract with Nancy M. Callahan, Ph.D., doing business as I.D.E.A. Consulting for the provision of technical assistance and support in behavioral health quality assurance activities, implementation of policies and procedures, establishment of outcome measures, and implementation of recommended services, provided under Amendment I to Agreement 5484 because (B) “Specialty skills and qualifications not expressly identified in classifications are involved in the performance of the work;”
2) Approve and authorize the Chair to sign Amendment I to Agreement for Services 5484 with Nancy M. Callahan, Ph.D., doing business as I.D.E.A. Consulting, increase the not to exceed amount from $150,000 to $779,953 and extending the term through December 31, 2025 with no change to the rates; and
3) Authorize the HHSA Director, or designee, to execute further documents relating to Agreement 5484, contingent upon approval by County Counsel and Risk Management, including amendments which do not increase the maximum dollar amount or term of the Agreement. (Cont. 3/22/2022, Item 20)
FUNDING: 29% Medi-Cal Quality Assurance, 5% Behavioral Health Realignment, 5% Mental Health Services Act, 24% Crisis Care Mobile Unit, 9% Behavioral Health Quality Improvement, 13% Behavioral Health Continuum Infrastructure Program, 15% Mental Health Services Block Grant American Rescue Plan Act.
Staff recommending this item be Continued off Calendar.
Body
DISCUSSION / BACKGROUND:
On February 25, 2020 (Legistar item 20-0171), the Board of Supervisors approved Agreement 4603 with Nancy M. Callahan, Ph.D., doing business as I.D.E.A. Consulting, to provide assessment, analysis, and recommendations regarding the Behavioral Health Adult System of Care for a twelve-month term from date of execution on February 25, 2020 through February 24, 2021. On March 9, 2021 (Legistar item 21-0298), the Board received a presentation of the results of this Systems Analysis and Recommendations Report from the Health and Human Services Agency (HHSA) and I.D.E.A. Consulting, that outlined the current El Dorado County Behavioral Health system of care and made recommendations for strengthening the system to promote positive outcomes, wellness, and recovery.
As a result of the recommendations made to the County in accordance with Agreement 4603, the Board of Supervisors approved Agreement 5484, with I.D.E.A. Consulting on March 23, 2021 (Legistar item 21-0292), to provide services including but not limited to: (1) to develop and expand the existing system to meet all state and federal requirements, including the development of a data dashboard and other data models to demonstrate access, quality, cost effectiveness, and outcomes; (2) to develop practice guidelines for the mental health and substance use disorder programs; and design, collect, and analyze data to measure outcomes and performance for Behavioral Health programs; (3) to provide consultation and mentoring to the Behavioral Health staff for their Quality Improvement and Compliance program and support Behavioral Health staff in preparing for the annual External Quality Review of mental health and substance use disorder programs; and (4) grant writing.
Behavioral Health has recently been awarded three different grants that are used to directly address the recommendations from the I.D.E.A. Consulting assessment, to strengthen services in collaboration with county partner agencies in El Dorado County. A fourth funding stream has also been awarded to Behavioral Health that can be incorporated into the work that I.D.E.A. Consulting is doing, as the funding is provided to meet the State's requirements regarding our County participating in the CalAIM (California Advancing and Innovating Medi-Cal) effort. CalAIM is a long-term commitment to transform and strengthen Medi-Cal, with a goal of offering Californians a more coordinated and person-centered approach to maximizing their health and life trajectory. The following descriptions reflect how the four funding streams will be used by I.D.E.A. Consulting, and for what purpose:
1) The Crisis Care Mobile Unit (CCMU) planning grant will allow Behavioral Health to engage stakeholders in discussion on the development of 24/7 mobile crisis team proposal, that could then be submitted to the Department of Health Care Services (DHCS). Dr. Callahan and her staff will support Behavioral Health throughout a series of stakeholder meetings, will document the discussions, and will combine the community discussions and feedback into a final proposal that will be submitted to DHCS in February 2023.
2) The Behavioral Health Continuum Infrastructure Program (BH-CIP) planning grant allows Behavioral Health to convene and engage community stakeholders and system delivery partners to identify gaps in Behavioral Health services; and develop strategies and recommendations for building an Action Plan that has prioritized goals, objectives, and strategies for expanding Behavioral Health capacity as a comprehensive continuum of care across all regions of the county. Dr. Callahan and her staff will provide support to Behavioral Health in the convening process of the stakeholder meetings and in developing and finalizing the Action Plan by December 2023.
3) The Mental Health Services Block Grant (MHBG) will allow Behavioral Health to expand services provided to individuals experiencing a first episode psychosis. Dr. Callahan and her staff will provide guidance through June 2025 to the current provider, Sierra Child and Family Services. Dr. Callahan and her staff will evaluate the provider's services and outcomes, and will also prepare reports that have to be submitted regularly to DHCS.
4) Lastly, Behavioral Health has been awarded Behavioral Health Quality Improvement (BH-QIP) funding from DHCS to support the implementation of the statewide CalAIM effort. Dr. Callahan and her staff will support Behavioral Health in the implementation of CalAIM to ensure that all qualitative and reporting measurements to DHCS are met.
Amendment I is necessary to incorporate the funding from these various grant activities and Quality Assurance (QA) support into the existing agreement. As Behavioral Health services are incorporated into CalAIM, and as Dr. Callahan and her staff are supporting HHSA in the development of efficiencies and expanded Behavioral Health Services throughout the County per the I.D.E.A. Consulting assessment, it is prudent to coordinate these funding streams together to maximize I.D.E.A. Consulting 's expertise and time within these activities.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the Behavioral Health Division would not have the technical assistance, guidance, or assistance with the convening of the stakeholder meetings for the CCMU and BH-CIP grants, the writing of the CCMU proposal and BH-CIP Action Plan, the evaluation and reporting activities required as part of the MHBG, and with the implementation of the CalAIM requirements. Also, this would reduce the likelihood that Behavioral Health will be able to carry out the recommendations from the I.D.E.A. Consulting assessment, which are geared toward improving access to services and expanding services for eligible residents.
PRIOR BOARD ACTION:
1) 02/25/20, 20-0171, Approval of Agreement 4603
2) 02/24/21, 21-0298, I.D.E.A. Consulting Board presentation
3) 03/23/21, 21-0292, Approval of Agreement 5484
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:
With the exception of $75,000 which will be paid with Behavioral Health Realignment and MHSA funding, the additional costs will be covered with grant funding or additional funds allocated by the State, resulting in no impact to Net County Cost. Sufficient appropriations are included in the Fiscal Year 2021-22 Budget and will be included in future budgets for the term of this Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) originals of Amendment I to Agreement for Services 5484; and
2) Clerk of the Board to return one (1) fully executed Amendment I to HHSA Contracts Unit at 3057 Briw Rd, Suite B.
STRATEGIC PLAN COMPONENT:
Healthy Communities and Good Governance
CONTACT
Don Semon, Director, Health and Human Services Agency