Approve third amendment to Agreement No. 23-160 with Victor Community Support Services to add funding in the amount of $25,101 for 2024-25 for a new contract maximum of $767,726, for the period of July 1, 2023 through July 31, 2024, for the provision of community based Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for seriously emotionally disturbed children and youth. (No general fund impact) (Sullivan)

Approve third amendment to Agreement No. 23-160 with Victor Community Support Services to add funding in the amount of $25,101 for 2024-25 for a new contract maximum of $767,726, for the period of July 1, 2023 through July 31, 2024, for the provision of community based Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for seriously emotionally disturbed children and youth.

In January 2022, California Department of Health Care Services (DHCS) rolled out the California Advancing and Innovating Medi-Cal (CalAIM) initiative aimed to provide broad delivery system program and payment reform across the Medi-Cal system. The goal was transformation of the Medi-Cal delivery system, moving it towards a population health approach that prioritizes prevention and whole person care. Focus shifted 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 was required to revise the terms and conditions in the provider agreements for these services. On or about June 27, 2023, the County and Victor Community Support Services entered into a new Agreement for the provision of Community Based EPSDT services in an amount of $610,500 for the period of July 1, 2023 through June 30, 2024.

On or about October 10, 2023, the Parties amended the agreement which added funding in the amount of $75,000 for FY 2023-24, which was inadvertently omitted from the original agreement.

On or about May 7, 2024, the Parties amended the agreement which extended the term of the Agreement through July 31, 2024; added funding for July 2024; and added 2 monthly optional extensions for August and September 2024. The Agreement was extended pending a formal solicitation for these services. VCSS was selected from the solicitation and a new agreement was issued effective August 1, 2024.

HHSA requests approval of this third amendment which adds funding for July 2024. The additional funding is required to finalize payments under this agreement.  Victor Community Support Services was a selected provider following the competitive procurement in Spring 2024. Under the new agreement, beginning August 1, 2024, their agreement is to serve up to 125 youth while their prior agreement was to serve fewer youth. To begin scaling up services to reach the new capacity, the budget for July 2024 was exceeded; however, it is aligned with what would be expected given the increase in the number served in the month.

Performance Measures
The Performance Measures were included in the underlying Agreement and are not being revised at this time. (See. Att. B. Performance Measures)

This Agreement started on July 1, 2023, and since that time, Victor Community Support Services has performed satisfactorily and submitted quarterly RBA reports that support that performance. Victor Community Support Services provided these services for several years prior to the current contract term and performed satisfactorily during that contract term as well. During this contract term, Victor Community Support Services increased the capacity to serve youth by 30% with over 70% of new referrals receiving an intake within 14 days of referral.  Of youth discharged from treatment, approximately 80% successfully met their treatment plan goals. Throughout this agreement, Victor Community Support Services has worked collaboratively with HHSA, to both ensure children receive necessary clinical care and to provide evidence of satisfactory performance throughout the life of the agreement.

County Counsel has approved the amendment as to form.
General Services Department, Procurement Division.

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. The County 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 Victor Community Support Services met all the required qualifications necessary to successfully provide these services. 

Evaluation Criteria Included in RFP

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