Authorize the Chair to execute a renewal agreement with Yolo Community Care Continuum to provide Adult Residential Services through the Farmhouse Program in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative in an amount not-to-exceed $653,350 for the period of July 1, 2023 through June 30, 2024. (No general fund impact) (Sullivan)

On July 9, 2019, the County and Yolo Community Care Continuum entered into Agreement No. 19-144, which provided an initial term of July 1, 2019 through June 30, 2022, with two optional extensions for FY’s 2022-23 ($467,200) and 2023-24 ($467,200) for the provision of adult long-term residential treatment. The Farmhouse Program operates an adult rehabilitative residential facility that offers a group living environment. Adults live and work cooperatively at the Farmhouse Program, learning the skills necessary to transition from a highly structured treatment environment to a less structured independent living situation. The goals of this program are to help clients increase their ability to live independently through skill building, job training and/or other educational programs to further their independence and reducing costs to the County by reducing psychiatric hospital stays, Institute for Mental Disease (IMD) placements, and homelessness. On May 9, 2023, the contract amount for FY 2022-23 was increased to $675,700 via an amendment and the optional extension amount for FY 2023-24 was increased to $520,485.

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 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 19-144 currently provides an optional extension for FY 2023-24 ($520,485), due to the significant regulatory and claiming changes driven by the CalAIM initiative, the current agreement will expire on June 30, 2023, and cannot be extended on the same terms and conditions and must be replaced by a renewal agreement. HHSA now requests BOS approval of a one-year agreement with Yolo Community Care Continuum, for the provision of adult residential services in an amount not-to-exceed $653,350 for the period of July 1, 2023 through June 30, 2024, and delegated signing authority to the Yolo County Board Chair to assist with expediting execution of the renewal agreement.

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 January 30, 2019, the Yolo County Procurement Manager approved a sole source letter in conformance with the then current Yolo County Procurement Policy.