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Approve two contract amendments, a third contract amendment with Aldea, Inc. for $624,684 for a total contract amount of $1,884,238, and a first contract amendment with the Regents of the University of California, on behalf of its University of California, Davis Health System, for $139,316 for a total contract amount of $676,922, funded with Mental Health Services Act, Mental Health Block Grant and federal Short Doyle Medi-Cal, and extend both contract terms through June 30, 2018 in order to continue providing services for the early onset psychosis program; and Authorize the County Administrator to execute the amendments
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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 approve two contract amendments, a third contract amendment with Aldea, Inc. for $624,684 for a total contract amount of $1,884,238, and a first contract amendment with the Regents of the University of California, on behalf of its University of California, Davis Health System, for $139,316 for a total contract amount of $676,922, funded with Mental Health Services Act, Mental Health Block Grant and federal Short Doyle Medi-Cal, and extend both contract terms through June 30, 2018 in order to continue providing services for the early onset psychosis program; and Authorize the County Administrator to execute the amendments.
SUMMARY:
The Regents of the University of California, on behalf of its University of California, Davis Health System developed and piloted an evidence-based program at UC Davis Health System to treat youth and adults in the early stages of psychosis. The program has demonstrated effectiveness in reducing the impact of psychosis, including decreasing the need for hospitalization and long-term care and improving the level of functioning for those who are treated early in the development of psychosis. This proposed contract amendment and contract term extension will allow for continued implementation of the local Early Onset Psychosis Program. Aldea, Inc. provides clinical services to implement components of early intervention in the psychosis program including community education, screening, family support, medication management, and vocational and educational support services. This proposed contract amendment and contract term extension will expand the current age treatment category from 12-25 years of age to 12-30 years of age as the onset of psychosis for girls and women can occur as late as 26 years of age.
FINANCIAL IMPACT:
The Federal Substance Abuse and Mental Health Services Administration (SAMSHA), Mental Health Block Grant (MHBG) (FY2017/18 - $150,000), Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) (FY2016/17 - $635,388 and FY2017/18 - $549,585) and federal Short Doyle Medi-Cal (FY2017/18 - $28,414) provide funding for these contracts. The total contract amounts with the amendments are: UC Davis Health system $676,922 and Aldea, Inc. for $1,884,238. Appropriation is available in the FY2016/17 Adopted Budget and is included in the FY2017/18 Requested Budget. If funding for the contract is reduced or eliminated, the contract contains language that the County can modify or terminate the agreement with notice. There is no additional financial impact to the County General Fund.
DISCUSSION:
On August 12, 2014, the Board approved a contract with Aldea, Inc. for $1,259,554 for the period beginning August 1, 2014 through June 30, 2017 to provide early onset psychosis treatment services for individuals between the ages of 12-25 pursuant to the FY 2014/17 MHSA Three Year Integrated Plan. During the course of the three-year agreement, the County executed two departmental administrative amendments to clarify contractual deliverables and to make minor adjustments to the program’s budget without impacting the overall contracted maximum of the agreement. Approximately 335 individuals will be reached by prevention strategies such as outreach and education activities related to identifying the signs of the onset of psychosis, and extensive screening services for early onset psychosis. A minimum of 70 unduplicated clients will receive early psychosis treatment services. Anticipated outcomes include, but are not limited to:
• Less than 10 percent of clients enrolled in the treatment program will require hospitalizations for greater than seven days on an annual basis;
• 25 percent of the consumers receiving treatment will demonstrate improvement on the Clinical Global Impression (CGI) Scale at the sixth-month mark and 50 percent of the consumers receiving treatment will demonstrate improvement at the annual (12 month) mark.
This proposed contract amendment with Aldea for $624,684 for a total contract amount of $1,884,238 and proposed contract extension to June 30, 2018 expands the current age treatment category from 12-25 years of age to 12-30 years of age.
On November 25, 2014, the Board approved a contract with the Regents of California, Davis Health System to provide training and clinical supervision to Aldea, Inc. for the early onset psychosis program. The Early Diagnosis and Preventative Treatment (EDAPT) Program focuses on providing early intervention services for young people in the early stages of schizophrenia to avert the damage caused by long-term severe psychotic episodes. The UC Davis Health System will continue to provide training activities such as screening and assessment, supportive education and employment, individual treatment and psychotherapy, group interventions, including multifamily group, family support group, substance abuse management and peer support, peer and family advocacy, outcomes evaluation, and program administration. Clinical supervision will be provided to ensure that service frequency is individualized and based upon the need of each client. Outcomes include at least one evidence-based practice with a validated measurement tool to evaluate program efficacy for each Prevention Activity and Early Intervention Treatment Approach. This proposed contract amendment for $139,316 for a total contract amount of $676,922 and proposed contract extension to June 30, 2018 expands early onset psychosis treatment services as this program is a proactive intervention for treating those with emerging severe mental illness.
Contractors are required to submit monthly reports of their progress on deliverables and performance measures outlined in the agreements. The performance and outcome data for each contractor will be aggregated and analyzed by County staff annually and will be included in the State required MHSA Annual Update Report.
ALTERNATIVES:
The Board may choose not to approve the amendments with the UC Davis Health System and Aldea, Inc. This is not recommended as it would prevent the County from completing program requirements established in the MHSA Plan and result in a lack of adequate mental health services to individuals experiencing the onset of psychosis which may further result in increased negative outcomes for the County caring for this population, including increased hospitalizations and increased jail visits as well as increased costs to hospitals through costly Emergency Room (ER) visits.
OTHER AGENCY INVOLVEMENT:
The Solano County FY2014/17 and FY 2017/20 MHSA Integrated Plans were developed through a comprehensive, countywide planning process which gathered input from a variety of stakeholders, including community based organizations, service providers, law enforcement, hospitals and other medical providers, and mental health consumers and their families. County Counsel has reviewed the contract amendment for legal sufficiency.
CAO RECOMMENDATION:
ACCEPT DEPARTMENTAL RECOMMENDATION