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HomeMy WebLinkAboutMINUTES - 04242001 - C.184 • °' CONTRA .TO: BOARD OF SUPERVISORS COSTA FROM: FINANCE COMMITTEE %: COUNTY Federal Glover, Chair _5. ' Donna Gerber, Member V° sr`a coon`►'s DATE: April 24, 2001 SUBJECT: Competitive Bidding Process for Mental Health and Community Substance Abuse Contracts SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION Recommendation ACCEPT the report from the Finance Committee on the competitive bidding process for Mental Health and Community Substance Abuse contracts. Background On October 24, 2000, the Board of Supervisors acknowledged the Health Services Department's effort to create an equitable and consistent funding formula for contractor COLAs. In the same Board Order, the Board of Supervisors requested information on the RFP process for contracts in Mental Health and Community Substance Abuse Services to be presented to the Finance Committee within six months following the October meeting. The attached Health Services Administration's reports respond to the Board's directive. On April 2, 2001 the Finance Committee considered the reports and received testimony from the Health Services Department staff and from the Mental Health Coalition. After deliberation, the Committee accepted the attached reports. CONTINUED ON ATTACHMENT: X YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATUREIS): ACTION OF BOARD ON April 24, 2001 APPROVED AS RECOMMENDED x OTHER VOTE OF SUPERVISORS �j I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSENT _L->4— ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. Contact: ATTESTED April 24, 2001 John Sweeten,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR cc: Sara Haff=4 CAO BY ,DEPUTY How the Mental Health Division Contracts for Services Requests for Proposals The Mental Health Division contracts with approximately 25 non-profit community- based organizations to provide specialty services within its Adult/Older Adult System of Care and Children's System of Care. Many of these organizations have provided Systems of Care services for several years, modifying their programs as consumers' needs change. As new funding has come into the Mental Health Division, though, new organizational providers have been added. With the exception of a very few instances in which organizations were recruited to fill specific cultural and language competency needs, all services for which 1) new funding was available and/or 2) only one or a limited number of providers were needed were put out to bid through Requests for Proposals. This process was used to obtain the following services in recent years: • Oak Grove Crisis Residential and Day Treatment awarded to FamiliesFirst with State system.of care funding • Regional mental health support services for Ca1WORKS participants awarded to Rubicon Programs, Inc., Family Stress Center, and Touchstone Counseling Services with funding from Employment and Human Services Department (formerly Social Services) • Oak Grove Continuum of Care/Mobile Response Team awarded to Seneca Residential Services through federal Substance Abuse and Mental Health Administration (SAMHSA) grant • SERVE, Inc. vocational services put out to bid in response to the termination of an existing contract • Choices Juvenile Drug Court Treatment Program awarded jointly by the Mental Health Division, Community Substance Abuse Services, and the Probation Department to New Connections through federal Drug Courts Program Office grant • Crisis Residential Treatment Facility awarded to Bonita House, Inc. to be funded by County and Medi-Cal revenues • No award was made to operate an in-county, inpatient Institute for Mental Disease facility due to weaknesses in the two submitted proposals. The RFP processes used to award these contracts included notification to an extensive list of organizations doing relevant business throughout the San Francisco Bay Area and California. Mailing lists from such organizations as the California Association of Social Rehabilitation Agencies were used to ensure widespread announcement of requests for bids. Clarifying information was provided to prospective bidders through mandatory bidders's conferences and/or written questions with responses mailed to all those who had requested copies of the RFP. Submitted proposals were rated by review panels consisting of consumers, family members, service providers, and administration and finance staff. Rankings were submitted to the Mental Health Director (and jointly to the Community Substance Abuse Services Director and Chief Probation Officer in the case of the Juvenile Drug Court treatment program) for award decision and announcement. i Requests for Applications The Mental Health Division uses a less rigorous Request for Applications process when many providers of a given service are needed. This RFA process was used to compile the network of individual clinicians and organizational providers needed to implement Phase II of Medi-Cal consolidation. Recruitment began with letters sent to all licensed mental health therapists, psychologists and psychiatrists on lists provided by State certifying bodies. Virtually all licensed practitioners who responded to the announcement received contracts to the provider panel available to Medi-Cal beneficiaries. Application to this network remains open on an ongoing basis, and active recruitment through mass media and word-of-mouth is currently underway for providers in West County and East County and for providers with multilingual capability. A corps of attorneys qualified to conduct certification and capacity hearings for inpatient psychiatric patients in Contra Costa was recruited through an RFA. Notification of need for hearing officers was announced through local newspapers. Applicants were screened by County Counsel and Health Services officers as legislatively required. Those who met the qualifications were offered contracts. Contra Costa Regional Medical Center and Mt. Diablo Medical Pavilion engage hearing officers from among those who accepted contracts. Most recently, the RFA process was used in soliciting providers of Therapeutic Behavioral Services (TBS) and of Respite and Mentoring Services. TBS support is only available to youngsters who are already in the Children's System of Care so notification of the need for providers was distributed to all organizations under contract at that time (late 1999). A special informational meeting was held for prospective providers, and applications were judged in accordance with the TBS guidelines promulgated by the State Department of Mental Health. A more recent RFA process was used to solicit Respite and Mentoring Services providers. A network of such providers was desired so efforts were made to notify all youth-serving organizations about the RFA. Even those not experienced in delivering mental health services were invited to apply with the expectation of receiving extensive training. Non-competitive Contracts Market forces preclude the possibility of competitive bidding for some services needed by the Mental Health Division. For instance, the State operates locked, long-term psychiatric facilities such as Napa State Hospital. Less intensive Institutes for Mental Disease (IMDs) are rare, and the Mental Health Division seeks placement in those that are closest to Contra Costa County to facilitate contact by case managers and family members. The number of local board and care homes is also limited. When a consumer needs such housing, Mental Health Division case managers and housing coordinators negotiate individually with board and care home operators for shelter and augmented services based on locality and availability. 3/28/0416 / How Community Substance Abuse Services Division Contracts for Services Background Information: The Community Substance Abuse Services Division (CSAS) provides a continuum of services from prevention in the schools to residential treatment. Of the services provided by the CSAS Division, approximately 75% are contracted with community-based organizations that are locally based and usually have non-profit status. Factors Influencing the Contracting and RFP Process • Federal and State Demonstration Grants—A significant portion of the new funding received by the CSAS Division has been through competitive federal and state demonstration grants which are normally limited in duration from three to five5 years. In this particular competitive process, it is necessary for CSAS to identify specific providers prior to submission to the grant application. A successful application is partially linked to the expertise of the providers identified in the application. Several examples of this are the adult and juvenile drug court grants; the PIRA (Partners in Recovery Alliance) grant; and various grants for substance abusers who are pregnant and/or parenting. • Efforts to Develop Expertise and Capacity in the Existing Delivery System—In some instances, new funds are allocated to existing organizations in order to build on the strengths of these programs. The existing delivery system is underfunded as it currently exists. New funds are directed to existing organizations in instances where services will be improved through the existing infrastructure. Examples of this would be the direction of CalWORKS funds for pregnant and parenting women to existing women's service providers who provide these specialized services. • Statutory Limitations on the RFP Process—There are times when an RFP process is precluded by law. Examples of this involve Drug Medi-Cal contracts with narcotic replacement programs (methadone) and instances involving Driving Under the Influence (DUI) programs. • Redirection of Existing Funds—An RFP is issued in instances where the quality or amount of services do not meet contract requirements. Essentially this is a redirection of resources to a new contract provider. Examples of this would be the RFPing of outpatient services for the Pittsburg area. a c • New Funding—An RFP is issued when there is significant new funding that will allow for the expansion of the system of care. Recent examples of RFPs dedicated to new services are the Proposition 10 and Proposition 36 funding sources. RFP Process The CSAS Division attempts to widely distribute all RFP and RFA announcements. Both provider and grassroots organizations are notified of funding opportunities. Clarifying information is provided to RFP respondents through a bidders conference. Review criteria are established by CSAS administration and the proposals are carefully reviewed and rated by experts who have no direct interest in the final grant decision. Upon completion of the rating process, a recommendation is forwarded to the Health Services Director and ultimately to the Board of Supervisors. The Board of Supervisors makes the final decision in the awarding of contracts.