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Approve a first contract amendment with Caminar, Inc. for $2,016,475 for a total contract amount of $3,253,099 to consolidate and expand behavioral health Comprehensive Case Management services and extend the contract through June 30, 2024; Delegate authority to the County Administrator to execute this amendment and any subsequent amendments to this agreement, with County Counsel concurrence, up to an aggregate of $74,999; and Approve a $476,900 Appropriation Transfer Request to recognize unanticipated Mental Health Services Act, Community Services and Supports, revenue to fund the amendment (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 (H&SS) recommends that the Board of Supervisors approve a first contract amendment with Caminar, Inc. for $2,016,475 for a total contract amount of $3,253,099 to consolidate and expand behavioral health Comprehensive Case Management (CCM) services and extend the contract through June 30, 2024; delegate authority to the County Administrator to execute this amendment and any subsequent amendments to this agreement, with County Counsel concurrence, up to an aggregate of $74,999; and approve a $476,900 Appropriation Transfer Request (ATR) to recognize unanticipated Mental Health Services Act, Community Services and Supports, revenue to fund the amendment.
SUMMARY:
The Solano County H&SS Behavioral Health Division contracts with Caminar, Inc. to provide behavioral health treatment and case management services to individuals through three programs: Comprehensive Case Management (CCM) program and Co-Occurring Disorder (COD) Treatment program and the Felony Diversion Treatment program. CCM and COD are funded with Mental Health Services Act (MHSA) funding, and the Felony Diversion Treatment program is funded by the Department of State Hospitals. Services include mental health screening and assessment for individuals with mental health and/or substance use disorders who are in custody or living in the community, individualized re-entry plans for the justice-involved individuals, and behavioral health treatment services.
Caminar, Inc. provides services for each of the programs through three separate contracts. The recommended first contract amendment consolidates three separate contracts into one contract with Caminar, Inc. to streamline services under the Comprehensive Case Management (CCM) program to offer moderate intensity services for approximately 180 individuals referred by Solano County Behavioral Health. This updated program will focus on providing individuals with supportive psychiatric rehabilitation, intensive case management, and counseling focused on behavioral health issues that are critical for individuals in sustaining stability in their community setting and stepping down from higher levels of care. The provision of services is based on a detailed scope of work utilizing evidence-based treatment models to provide comprehensive case management services to seriously and persistently mentally ill consumers, including those with co-occurring substance use disorders living in the community and justice-involved individuals as requested by the court. Services include promoting personal recovery and wellness, coordinating placement and/or discharge planning with inpatient hospitals, rehabilitation centers and augmented board and cares, as needed, and additional ancillary supportive services.
FINANCIAL IMPACT:
The Caminar, Inc. contract is funded by the Mental Health Services Act, Community Services and Supports (CSS) component, as outlined in the MHSA Three-Year Plan, and grant funding from the Department of State Hospitals. Services are also Medi-Cal eligible. This amendment increases the initial contract by $2,016,475 for a new total contract amount of $3,253,099 and extends the contract through June 30, 2024. As the contract amendment is higher than budgeted appropriations, an ATR is needed to increase appropriations and recognize additional MHSA revenues in the department’s FY2023/24 Working Budget. There is no additional impact to the General Fund.
DISCUSSION:
The services provided by this contract are outlined in the Solano County MHSA Three-Year Plan FYs2023-26, which was approved by the Board on September 12, 2023. The MHSA Three-Year Plan includes funding for the new consolidated Comprehensive Case Management (CCM) which integrates Co-Occurring Disorder (COD) and Felony Diversion Treatment programs to provide comprehensive case management services for consumers with serious mental health conditions who may have co-occurring substance use disorders.
On May 25, 2021, the Board approved a grant award from the Department of State Hospitals (DSH) for $3,242,300 to provide felony diversion treatment through June 30, 2023; and a two-year contract with Caminar, Inc. for $775,085 to expand its diversion services to include serving individuals charged with felonies for the period of April 1, 2021 through June 30, 2023. On June 28, 2022, the Board then approved a first amendment with DSH that increased the grant award by $710,000 and extended the grant period through June 30, 2024.
On June 28, 2022, the Board approved two contracts with Caminar, Inc. for the period of July 1, 2022 through June 30, 2023. The first contract was for $332,651 to provide COD treatment services for serious mental illness and substance use clients and the second contract was for $1,236,624 to provide CCM treatment services. The new, recommended first contract amendment increases the contract for CCM treatment services by $2,016,475 for a total contract amount of $3,253,099 and expands the contract’s scope of work to integrate comprehensive case management services for the COD and Felony Diversion Treatment programs and extends the contract through June 30, 2024.
Solano County Behavioral Health collaborated with Caminar, Inc. on the development of this first contract amendment. Due to the complexities of consolidating the three programs the development of the contract and two funding sources, the contract amendment took longer than anticipated. Challenges included substantial changes to the scope of services, which required an in-depth review and alignment around activities, performance measures and reporting requirements.
The new consolidated Comprehensive Case Management (CCM) program offers intensive services to clients who experience serious and persistent mental health challenges and co-occurring substance use disorders. Merging the program activities into one contract streamlines efforts in managing and monitoring program delivery, clinical coordination, reporting requirements, and performance measures. These services will enable program participants to maintain independent community living and reduce hospitalizations, incarceration, and other more restrictive levels of care.
ALTERNATIVES:
The Board could choose not to approve this contract amendment with Caminar, Inc. This is not recommended as it would prevent the County from providing mental health services outlined in the MHSA Three-Year Plan and meeting the grant requirements of the DSH Felony Diversion Treatment program. Additionally, the services delivered through these programs are necessary to stabilize and treat individuals experiencing mental health and substance use disorders, and particularly individuals with behavioral health disorders as referred by the court.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION