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Health and Human Services Agency recommending the Board:
1) Approve and authorize the Chair to sign Amendment 2 to Agreement for Services 3524 with New Morning Youth and Family Services, Inc., for the provision of Specialty Mental Health Services for children and young adults, which increases the maximum obligation by $150,069, for a new maximum obligation of $600,239 with a retroactive effective date of November 1, 2020, with no other changes to the agreement terms;
2) Make findings in accordance with County Ordinance 3.13.030 that it is appropriate to contract with New Morning Youth and Family Services for services provided under this Agreement 3524 because (B) “Specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work”; and
3) Authorize the Purchasing Agent, or designee, to execute further documents relating to Agreement for Services 3524, including amendments which do not increase the maximum dollar amount or term of the Agreement, and contingent upon approval by County Counsel and Risk Management.
FUNDING: Federal/State Medi-Cal, Realignment and MHSA.
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DISCUSSION / BACKGROUND:
On December 4, 2018, the Board approved Agreement #3524 with New Morning Youth and Family Services (NMYFS) for the provision of Specialty Mental Health Services for children and young adults (File ID 18-1778, Agenda No. 12).
On April 21, 2020, the Board approved Resolution 075-2020 delegating authority to the Director of the Health and Human Services Agency (HHSA) to execute amendments to specified Behavioral Health Service Provider Agreements to temporarily alleviate cash-flow issues that resulted from the COVID-19 pandemic (File ID 20-0291, Agenda No. 33).
On June 9, 2020, the Director of HHSA signed Amendment 1 to Agreement #3524 with NMYFS so that HHSA could provide retroactive average monthly payments to the provider, to be terminated by HHSA at the end of the COVID-19 emergency.
Currently, HHSA is in receipt of invoices from NMYFS that exceed the total maximum obligation of the Agreement. The invoices are for November and December 2020 services. With this Amendment 2, HHSA would like to increase the maximum obligation of the Agreement by $150,069 for a new obligation of $600,239 in order to pay for the November and December invoices as well as ensure sufficient funds are available through the end of the Agreement, which is June 30, 2021.
HHSA staff are conducting more regular reviews of contract services and their respective invoices during the COVID-19 pandemic in an effort to anticipate any unforeseen challenges in meeting services demand during this unprecedented time. From these reviews, staff have indicated that since the time of the first enacted regional ‘stay at home orders,’ contract service providers overall have evidenced an average increase of approximately 35% demand for services. Similarly and specific to NMYFS, families receiving specialty mental health services (SMHS) have been identified as more frequently requesting additional and ongoing services. This is attributed to a variety of factors such as: families conducting school from home, increased child isolation, decreased child socialization, increased stress and anxiety, loss of employment for heads of household, and more. These impacts have continued to increase demand for these mandated services offered and contracted to NMYFS. This has also impacted HHSA’s ability to effectively monitor these contracts, as many of them are experiencing unprecedented use as result of COVID-19.
Acting as the Mental Health Plan for the County, the County has an obligation to pay for SMHS for eligible County clients in accordance with Welfare and Institutions Code (WIC) Section 5600 et seq., 5775 et seq., 14000 et seq., and 17000 et seq. Due to the identified increases in service provision for families, the most recent invoices received by HHSA for November and December have reached and surpassed the maximum obligation tied to Agreement #3524. As such, HHSA is requesting authorization to add Amendment #2 that would increase the maximum obligation of the Agreement by $150,069 for a new total obligation of $600,239, allowing payment to NMYFS, and in order to ensure sufficient funds are available to continue meeting local families’ mandated services need through the end of the Agreement, June 30, 2021.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide services through contracts with other vendors, however mandated service levels would likely not be met for families as this decision would limit HHSA’s capacity to meet the needs of the community. HHSA would also not be able to compensate NMYFS for work they performed in November and December, 2020.
PRIOR BOARD ACTION:
1) 12/04/20, 18, 18-1778, HHSA New Morning Youth and Family Services, 3524
2) 04/21/20, 15-1138, HHSA - Resolution to amend Service Agreements, COVID-19
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
HHSA is currently preparing multiple budget transfer requests for the Behavioral Health Division that will be brought to the Board for approval. Said requests will address the future funding of this amendment, and other active SMHS agreements.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Amendments 2 to Agreements for Services #3524.
2) Clerk of the Board to return one (1) fully executed Amendment to HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
County of El Dorado Strategic Plan Goal: Healthy Communities - Improved health, well-being and self-sufficiency of El Dorado County communities, residents, and visitors.
CONTACT
Don Semon, Director