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Approve a contract with Aldea Children and Family Services for a total contract amount of $217,992 to provide Cognitive Behavioral Therapy for Psychosis treatment services to youth and young adults up to age 25 years old with high-risk behavioral health conditions for the current period of July 1, 2024 through June 30, 2025; Delegate authority to the County Administrator to execute the contract and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999; and Approve a $217,992 Appropriation Transfer Request to recognize unanticipated grant revenue to fund the contract (4/5 vote required)
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Published Notice Required? Yes ____ No _X _
Public Hearing Required? Yes ____ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services recommends that the Board of Supervisors approve a contract with Aldea Children and Family Services for a total contract amount of $217,992 to provide Cognitive Behavioral Therapy for Psychosis (CBT-P) treatment services to youth and young adults up to age 25 years old with high-risk behavioral health conditions for the current period of July 1, 2024 through June 30, 2025; delegate authority to the County Administrator to execute the contract and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $47,999; and approve a $217,992 Appropriation Transfer Request to recognize unanticipated grant revenue to fund the contract (4/5 vote required)
SUMMARY:
In November 2023, Behavioral Health submitted a grant proposal in collaboration with Aldea Children and Family Services to the Mental Health Services Oversight and Accountability Commission (MHSOAC) for Round 5: Early Intervention Programs and Practices. In March 2024, Behavioral Health received a notice of a $750,000 grant award. Aldea is the only regional provider of Supportive Outreach and Access to Resources (SOAR) First Episode Psychosis (FEP) program, an evidence-based early intervention program. service which provides early intervention services to individuals who have experienced a psychotic episode within the last two years or currently have subthreshold symptoms of psychosis.
This grant award provides funding for Aldea to implement Cognitive Behavioral Therapy for Psychosis (CBT-P) evidence-based, culturally responsive, treatment services for clinically eligible youth and young adults to improve access to critical behavioral health interventions for youth who do not fully meet the criteria for the SOAR First Episode Psychosis (FEP) program fidelity but still need similar services which assist in avoiding utilization of higher acuity care.
In July 2024, a $750,000 subaward revenue agreement with Heluna Health was executed for the current period through June 30, 2025. Heluna Health is the third-party administrator on behalf of the Department of Health Care Services (DHCS) to oversee the implementation of the Children and Youth Behavioral Health Initiative (CYBHI) grant on Early Intervention Programs and Practices.
FINANCIAL IMPACT:
The Aldea contract will be funded with grant revenue received for the CYBHI on Early Intervention Programs and Practices. Approval of the Appropriation Transfer Request (ATR) will recognize $217,992 in unanticipated grant revenue in the Department’s FY2024/25 Working Budget to fund the contract.
Heluna Health has indicated that the grant award term will be extended to June 30, 2026. Once an official grant extension notification is received from Heluna Health, Solano Behavioral Health will include remaining grant funds in their FY2025/26 Requested Budget and the subcontract with Aldea will be amended to add the remaining grant funds and extend the contract through June 30, 2026 for second-year implementation of the program and recommended for the Board’s approval.
DISCUSSION:
Authorized as part of the 2021 Budget Act, the CYBHI is a multi-year, multi-department package of investments that reimagines the systems that support behavioral health and wellness for all California’s children, youth, and their families. Efforts focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health needs for children and youth ages 0 - 25 years.
Solano County Behavioral Health staff and Aldea’s FEP program staff identified a gap in the care continuum for clients experiencing psychosis who do not meet the narrow eligibility criteria for treatment in the Coordinated Specialty Care FEP program. Such clients most often have a duration of untreated psychosis that exceeds the two-year window limit established by the Coordinated Specialty Care FEP eligibility criteria yet these clients still require intensive services, the support of a coordinated treatment team, such as Coordinated Specialty Care with integrated prescriber, therapist, case manager, and program coordinator, and treatment with a high-fidelity evidence-based practice with demonstrated outcomes.
Aldea is an established provider of behavioral health and specialty mental health services and is experienced in providing services to the population of focus. The grant funds will allow Aldea to establish the new Aldea Counseling Services Psychosis (ACS-P) program as an extension of the current early psychosis treatment program referred to as SOAR. The DHCS CYBHI grant will support the necessary Aldea staff needed for building a sustainable program, accounting for training time, clinical growth and treatment proficiency, and supervision needed for a successful program.
This program will complement the existing continuum of care and will address a void whereby Aldea is serving clients with psychosis who meet SOAR criteria but not serving those high-needs clients who do not meet SOAR criteria. Due to high levels of psychosis, these clients are often languishing in the gaps and are not benefiting from other Solano Behavioral Health services. The program will allow for a Coordinated Specialty Care (CSC) team to support these clients. The lasting impact of this project includes community education, de-stigmatization of psychosis interventions and treatment, broad community outreach and education, and expedited clear pathways for effective treatment that supports young people and their families.
Beginning July 2024, Solano Behavioral Health and Aldea key program staff began finalizing the program scope, referral structure, and clinical procedures required to implement the program, such as assessment, evaluation tools and treatment procedures, and attend state mandated grantee meetings. Additional meetings occurred to develop the implementation plan and program budget in alignment with the grant agreement deliverables. No client services have been provided during the implementation and start-up phase for the program.
ALTERNATIVES:
The Board may choose not to approve the contract with Aldea and the ATR; however, this is not recommended as the grant funding provides CBT-P treatment services for youth and young adults experiencing psychosis who are not eligible for mental health services from the existing programs in the county.
OTHER AGENCY INVOLVEMENT:
The Department of Health and Social Services has worked closely with Aldea Children and Family Services, Solano County Office of Education, area schools, and other local agencies for client referrals. Solano County Behavioral Health and Aldea are also in partnership with University of California at Davis for training and consultation on early treatment psychosis.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION