Approve agreement with the Regents of the University of California, on behalf of University of California Davis Health (UCD Health), in the amount of $294,500 for the period of July 1, 2024 through June 30, 2025 for the provision of early diagnosis and preventative treatment (EDAPT) services. (No general fund impact) (Morales)

The County via the Health and Human Services Agency (HHSA) applied for and was awarded a Substance Abuse and Mental Health Services Administration (SAMHSA) Mental Health Block Grant Ten Percent Set Aside allocation (MHBG 10%) for First Episode Psychosis (FEP) programs from the California Department of Healthcare Services. HHSA initially entered into an agreement with UCD Health for the period of July 9, 2019 through June 30, 2024 for these services.

HHSA staff now requests approval of this agreement so that HHSA will be able to continue partnering with UCD Health to serve transition age youth (TAY) who are beginning to show signs or symptoms of serious mental illness. This collaborative program includes a variety of clinical and other supportive services including EDAPT. EDAPT is an ambulatory clinical and research program based in the Department of Psychiatry and Behavioral Sciences at UCD Health. This program was founded upon thirteen (13) years of clinical and research experience with early psychosis patients by the program director, Cameron Carter, M.D. The EDAPT clinic provides comprehensive diagnostic and treatment services for children and young adults who have recently developed or are at high-risk of developing a psychotic disorder. The goals of the clinic are to intervene as early as possible to mitigate illness progression, prevent development of disease-related impairment, and limit treatment-related side effects. Through this work, County residents have been empowered to become active participants in their treatment and to make significant progress toward their personal, social, and occupational goals.

The HHSA Director has approved the start date of the agreement to be backdated to July 1, 2024. Due to the necessity of the services and the risk of not providing services to TAY who are beginning to show signs and symptoms of serious mental illness, including first episode psychosis, UCD Health has been providing services since the end of the last agreement June 30, 2024. The contracting process has been handled with urgency but due to the complexity of the agreement, execution has taken an unprecedented amount of time. Upon execution of the Agreement, HHSA will issue an option letter to extend the agreement through fiscal year 2025-26.

County Counsel
General Services Department, Procurement Division

On April 15, 2024, the then acting Yolo County Deputy Director/Purchasing Agent or designee approved a sole source procurement for these services. Factors considered included, but were not limited to: 1) UCD Health is the closest provider of these services to the County; 2) UCD Health is a major purveyor of these services and helped in the development of this program; 3) UCD Health is the only agency in the greater Northern California area that provides a FEP training and an education program. 

Each County that receives SAMHSA MHBG 10% for First Episode Psychosis (FEP) program is required to partner with an agency who provides services and treatment. Without sole source approval, SAMSHA would recall the funding, and the County would not be able to continue providing these services.

Vendor Performance
There are no current performance measures data to report for this agreement as it is a new agreement. The Performance Measures associated with this Agreement are included in Att. B. Performance Measures and will be available to this Board and the public over the term of the agreement.

During the prior agreement, clients served were able to transition from full coordinated specialty care to a ‘step down’ version of this program, which is more aligned with general adult/TAY outpatient services. Using symptom rating tools, clients were observed to have a decrease in their mental health symptoms and an increase in social and role functioning. Clients served in EDAPT also exhibited a reduction in hospitalization or residential treatment placements while they were engaged in the program.

UCD Health has partnered closely with HHSA to design their program offerings to best meet the needs of the agency and the youth they serve. They have provided outreach to support the early identification of severe mental illness, including psychosis as well as the full array of EDAPT clinical services to youth who qualify. Because of the intensity of services, UCD Health can only serve a small number of youth at a time, so the data provided to HHSA semi-annually is reflective of a small clinical population.