Authorize the Chair to execute a renewal agreement with TLCS, Inc. dba Hope Cooperative to provide Full-Service Partnership (FSP) Services in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative in an amount not-to-exceed $6,390,880 for the period of July 1, 2023 through June 30, 2024. (No general fund impact) (Sullivan)

On or about November 19, 2020, Yolo County issued a formal request for proposal (details below) to solicit a provider for Mental Health Services Act (MHSA) Full-Service Partnership (FSP) Services. FSP services aim at preventing consumers from requiring higher levels of care or needing support in transitioning back into the community after being placed in a high level of care, like institutions for mental disease, acute psychiatric hospitals, and state hospitals. These services are community based intensive services patterned upon evidenced based practices and incorporate Mental Health Services Act (MHSA) concepts of wellness, recovery, resiliency, and attention to client driven services. The primary outcome objectives for these services are to decrease the utilization and length of stay in costlier and more restrictive levels of care; reduction in homelessness; reduction in incarceration; increase in school and/or vocation program enrollment; increase in consumer employment and increase support of consumers and their families and caregivers. FSP programs provide comprehensive and intensive mental health services and employ a “whatever it takes” community-based approach using innovative interventions to help people reach their recovery goals. These services must be available to support clients 24-hours a day, seven (7) days per week and target a length of stay of 18 to 24 months, as an average, for all clients served.

The resulting agreement was awarded to TLCS, Inc. dba Hope Cooperative and on June 8, 2021, the County and TLCS, Inc. dba Hope Cooperative entered into Agreement No. 21-117, which provided an initial term of April 1, 2021 through June 30, 2023, with two optional extensions for FY’s 2023-24 ($2,539,236) and 2024-25 ($2,539,236). On or about December 6, 2022, the Agreement was amended to increase the optional extensions for FY’s 2023-24 ($4,185,014) and 2024-25 ($4,185,014).

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 No. 21-117 provided two optional extensions for FY’s 2023-24 ($4,185,014) and 2024-25 ($4,185,014), 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 TLCS, Inc. dba Hope Cooperative to provide FSP services in an amount not-to-exceed $6,390,880 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. Based on guidance from County Counsel and the Procurement Division the optional extension for FY 2024-25 ($4,185,014) 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 update County long form contract boilerplate.

Performance Measures
Performance measures were included in Agreement No. 21-117. 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 November 19, 2020, the County issued a formal solicitation via a request for proposal (RFP) for the provision of Mental Health Services Act (MHSA) Full-Service Partnership (FSP) Services from qualified community-based organizations. The RFP was open for 62 days (just over 8 weeks), and staff offered potential bidders an opportunity to ask questions during a Mandatory Bidders’ Conference on December 4, 2020.

The County received six proposal(s) from this solicitation.  The proposal submitted by TLCS, Inc. dba Hope Cooperative was selected as one of the top choices by all members of the Review Committee and was evaluated and determined to meet all the required qualifications necessary to successfully provide these services. 

Additional information regarding the Competitive Bid Process is provided below, including a summary of the RFP evaluation criteria.

Evaluation Criteria Included in RFP
· General Company Information (30 points)
· Experience (118 points)
· Vendor Approach to the Project (235 points)
· Cost Proposal (15 points)
· Responsiveness/Responsibility (18 points)
· Quality Assurance and Oversight (15 points)
· Financial Information (25 points)
· Past Performance (25 points)
· Reasonableness of Cost (48.1 points)
· Quality and Completeness of the Proposal (pass/fail)