Authorize the Chair to execute a renewal agreement with Yolo Community Care Continuum for the provision of Adult Crisis Residential Services at Safe Harbor in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative in an amount not-to-exceed $400,000 for the period of July 1, 2023 through December 31, 2023. (No general fund impact) (Sullivan)

On July 7, 2020, the County and Yolo Community Care Continuum entered into Agreement No. 20-179, which provided an initial term of July 1, 2020 through June 30, 2023, with two optional extensions for FY’s 2023-24 ($800,000), and 2024-25 ($800,000) for the provision of adult crisis residential services at Safe Harbor. Safe Harbor is a crisis residential facility that provides short–term residential treatment options for clients in psychiatric crisis that can effectively prevent a voluntary/involuntary psychiatric hospital stay and who meet the Medi-Cal mental health medical necessity criteria. Safe Harbor also provides a more supportive step-down option after a psychiatric hospital stay to help prevent the return of a crisis and support a more stable return to the community and outpatient behavioral health services.

California Advancing and Innovating Medi-Cal (CalAIM) Initiative
In January 2022, California Department of Health Care Services (DHCS) rolled out the CalAIM initiative that aims to provide broad delivery system program and payment reform across the Medi-Cal system. The goal is transformation of the Medi-Cal delivery system, moving it towards a population health approach that prioritizes prevention and whole person care. Focus shifts from compliance to quality and performance metrics. Specialty Mental Health Services (SMHS) requirements and policies pursuant to the CalAIM initiative were updated, and as a result of these updates, the County is required to revise the terms and conditions in the provider agreements for these services. In preparation for this system wide change, the County has been working closely with CalMHSA who has been providing the County and other SMHS Medi-Cal counties with technical assistance around the CalAIM initiative. The County has received new boilerplate templates from CalMHSA for both DMC/SUD treatment services and SMHS Medi-Cal services that include updated programmatic regulatory requirements and updated billing/claiming requirements. County is working on finalizing a new Yolo County SMHS Medi-Cal boilerplate that is in compliance with these changes, a draft of which is attached hereto as Att. A. Draft Yolo County SMHS boilerplate.

The renewal agreement requested in this staff report will be drafted and executed on the finalized Yolo County SMHS boilerplate. County Counsel and the Procurement Division are participating in the review and finalization of the Yolo County SMHS boilerplate. However, due to the timeliness in which the County has been receiving information from DHCS, especially regarding rates, final boilerplate language is still pending. Approval of this request herein will enable the Yolo County Health and Human Services Agency (HHSA) to expedite processing and approval of the renewal agreement to minimize any lapse in services once we have all of the information from DHCS and have negotiated final rates with our providers.

While Agreement No. 20-179 provided two optional extensions for FY’s 2023-24 ($800,000), and 2024-25 ($800,000), due to the significant regulatory and claiming changes driven by the CalAIM initiative, the current agreement cannot be extended on the same terms and conditions and must be replaced by a renewal agreement. HHSA now requests BOS approval of a 6-month extension of the agreement with Yolo Community Care Continuum, for the provision of adult crisis residential services in an amount not-to-exceed $400,000 for the period of July 1, 2023 through December 31, 2023, and delegated signing authority to the Yolo County Board Chair to assist with expediting execution of the renewal agreement. This renewal agreement will also include one 6-month optional extension through June 30, 2024, in an amount not-to-exceed $400,000.

Based on guidance from County Counsel and the Procurement Division the optional extension for FY 2024-25 ($800,000) will not be included in this renewal agreement. County Counsel and the Procurement Division are working on updating the County long form contract boilerplate that will be forthcoming sometime in FY2023-24. County Counsel and the Procurement Division would like any extensions beyond June 30, 2024 to be drafted on the updated County long form contract boilerplate.

Performance Measures
Performance measures were included in Agreement No. 22-52 See Att. B. Performance Measures. These performance measures or similar performance measures will also be included in the renewal agreement.

County Counsel - review and approval of the Yolo County SMHS boilerplate
County Counsel - review and approval of the resulting renewal agreements as to form
Department of General Services, Procurement Division
CalMHSA - technical assistance with CalAIM Initiative

On or about August 31, 2020, the Yolo County Procurement Manager approved a sole source letter in conformance with the then current Yolo County Procurement Policy.

HHSA confirms Yolo Community Care Continuum has performed satisfactorily under this agreement. Thus, pursuant to the authority provided to the County Procurement Manager as the County Purchasing Agent under the current Yolo County Procurement Policy, the Procurement Manager has determined that it is in the best interest of the County to extend this Agreement, based on satisfactory service and to avoid the interruption of County business.  A formal solicitation for these services is planned to be released in FY 2023-24 for a targeted contract start date of January 1, 2024.