Authorize the Chair to execute a renewal agreement with Turning Point Community Programs to provide Community Based Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative in an amount not-to-exceed $1,012,973 for the period of July 1, 2023 through June 30, 2024. (No general fund impact) (Sullivan)

On April 2, 2018, the County issued a competitive solicitation via request for proposals (RFP) from qualified community-based organizations to provide Children’s Outpatient Mental Health Treatment Services, including Community Based EPSDT services (formerly known as “Primary Services”) and Intensive Services.  Community Based EPSDT services are designed to serve the largest group of eligible children and youth, targeting Medi-Cal beneficiaries. These services are provided in the community and sometimes in the office.  Referrals to Community Based EPSDT services are the most common initial referral made for a child or youth.  Intensive Services include Therapeutic Behavioral Services (TBS); Children’s MHSA-FSP Services; and the Wraparound Program. Intensive Services target children and youth under the age of 21 with high levels of need with the provision of intensive home and community-based programs. Intensive Services may include all of the services provided under Community Based EPSDT Services.

The resulting agreement was awarded to Turning Point Community Programs and on October 9, 2018, the County and Turning Point Community Programs entered into Agreement No. 18-222, which provided an initial term of September 1, 2018 through June 30, 2019, with four optional extensions for FY’s 2019-20 ($1,169,273), 2020-21 ($1,169,273), 2021-22 ($1,169,273) and 2022-23 ($1,169,273). The County has exercised all the available optional extensions under Agreement No. 18-222.

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 one-year 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.

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 one-year extension of the agreement with Turning Point Community Programs to to provide Community-Based EPSDT services in an amount not-to-exceed $1,012,973 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. A formal solicitation for these services is planned to be released in FY 2023-24 and a resulting agreement will be issued for FY2024-25.

Performance Measures
Performance measures were included in Agreement No. 18-222. 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 April 2, 2018, the County issued a competitive solicitation via request for proposals (RFP) from qualified community-based organizations to provide Children’s Outpatient Mental Health Treatment Services, including Community Based EPSDT services (formerly known as “Primary Services”) and Intensive Services.  Community Based EPSDT services are designed to serve the largest group of eligible children and youth, targeting Medi-Cal beneficiaries. These services are provided in the community and sometimes in the office.  Referrals to Community Based EPSDT services are the most common initial referral made for a child or youth.  Intensive Services include Therapeutic Behavioral Services (TBS); Children’s MHSA-FSP Services; and the Wraparound Program. Intensive Services target children and youth under the age of 21 with high levels of need with the provision of intensive home and community-based programs. Intensive Services may include all of the services provided under Community Based EPSDT Services.

The RFP was open for 46 days (just over 6 weeks).  On April 12, 2018, potential bidders were offered an opportunity to ask questions during a Mandatory Bidders’ Conference on April 19, 2018, additional questions concerning the RFP could be asked via the Bidsync website. HHSA received six proposal(s) from this solicitation.

A six-person Proposal Review Committee was formed that included 3 HHSA employees, from 2 different HHSA branches, as well as 3 other reviewers. The Review Committee evaluated the proposals and determined that the proposal submitted by Turning Point Community Programs met all the required qualifications necessary to successfully provide these services. 

Evaluation Criteria Included in RFP
· Qualifications (30 points)
· Experience (30 points)
· Description of Vendor Operations (25 points)
· Vendor’s Approach to Project (60 points)
· Demonstrated Competence/Past Performance (20 points)
· Responsiveness/Responsibility (15 points)
· Quality and Completeness of Submitted Proposal (30 points)
· Financial Stability (15 points)

Bids Received

Bidder	Bid	Services Awarded	Awarded Amount	BOS Approval Date
CommuniCare Health Centers	$1,737,661	Community Based EPSDT Services (Primary Services)	$1,250,203	10/23/2018
		Intensive Services-Wraparound	$552,847	11/06/18
Heritage Oaks Hospital	$231,199	None	n/a	n/a
North America Mental Health Services (NAMHS)	$2,662,400	None	n/a	n/a
Stanford Youth Solutions	$3,846,333	Community Based EPSDT Services (Primary Services)	$834,207	9/25/2018
Turning Point Community Programs	$1,908,102	Community Based EPSDT Services (Primary Services)	$930,102	10/09/2018
		Intensive Services-MHSA FSP Services	$354,553	9/25/2018
		Intensive Services TBS	$370,577	10/09/2018
Victor Community Support Services	$1,775,269	Community Based EPSDT Services (Primary Services)	$571,250	9/25/2018
		Intensive Services-Wraparound	$619,583	10/23/2018

The proposals from Heritage Oaks and NAMHS were not awarded a contract.

HHSA confirms Turning Point Community Programs has performed satisfactorily under Agreement No. 18-222. 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 enter into a one-year renewal 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 and a resulting agreement will be issued for FY2024-25.