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Approve a 3 year contract with Bay Area Community Services for $2,943,000 to provide ongoing services for the Whole Person Care Pilot Program for the period beginning August 1, 2018 through June 30, 2021; and Authorize the County Administrator to execute the contract and any subsequent amendments that remain within budget appropriations
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board approve a 3 year contract with Bay Area Community Services for $2,943,000 to provide ongoing services for the Whole Person Care Pilot Program for the period beginning August 1, 2018 through June 30, 2021; and Authorize the County Administrator to execute the contract and any subsequent amendments that remain within budget appropriations.
SUMMARY:
The Whole Person Care (WPC) program is a 5 year pilot that focuses on increasing coordination and access to care, reducing inappropriate hospital utilization, improving data collecting and sharing, and improving overall health outcomes for the WPC population which are identified as high-risk participants with two or more chronic and serious health conditions. Effective October 25, 2016, H&SS has provided oversight for the WPC program and has utilized grant funding, a total of $4,667,010 over five years, to contract with the Solano Coalition for Better Health (SCBH). SCBH has administered WPC through outreach and engagement and complex care management.
On March 20, 2018 in accordance with County purchasing guidelines, H&SS issued a Request for Proposals (RFP) for the remaining three years of the WPC pilot. The Evaluation Committee reviewed each RFP received and on May 29, 2018, Bay Area Community Services (BACS) was selected as the apparent best-evaluated Proposer. H&SS is requesting that the Board approve a new multi-year contract with BACS for $2,943,000 to lead the County’s WPC Pilot in order to begin the transition process for existing WPC clients.
FINANCIAL IMPACT:
A combination of WPC grant funding and 1991 Public Health and Mental Realignment will provide funding for this contract. 1991 Mental Health Realignment is being used as a match for the WPC grant funding. For program costs not covered with grant funding, 1991 Public Health Realignment will provide reimbursement. Appropriation is available in the Department’s FY2018/19 Adopted Budget for this agreement.
DISCUSSION:
On October 25, 2016, the Solano County Board of Supervisors accepted the State Department of Health Care Services (DHCS) approval of the WPC Pilot program which awarded grant funds totaling up to $4,667,010 over five years. Solano’s WPC Pilot continues to make strides in achieving the Triple Aim of Health Care: better quality services at lower costs and high patient satisfaction. WPC efforts include: increase integration among County agencies, health plans, providers and other community organizations; increase coordination and appropriate access to care; improve data collection and information sharing; reduce inappropriate emergency and inpatient utilization; and improve health outcomes for the WPC population. This population is identified as individuals of multiple health systems that continue to have poor outcomes in which emergency department visits serve as the default care rather than utilizing preventative services such as being seen in a primary care environment. Solano’s specific target population includes residents with two or more chronic and serious health conditions, at least one of which is a mental health and/or substance use disorder.
The H&SS Divisions of Public Health, Behavioral Health, Medical Services, and Administration partnered with the SCBH in the first two program years (2016 and 2017), overseeing various aspects of the pilot such as outreach and engagement, care coordination, privacy and security guidance, data analysis, and developing policies and procedures. Emphasis during the initial eighteen months was performing assertive outreach and engagement in order to obtain a target enrollment goal of 50 individuals by the end of program year two. The WPC Pilot expects to enroll 250 clients during the five-year period. To date, WPC enrollment is over 50% of the target goal at 129 WPC participants. WPC participants were able to connect with a primary care physician, receive transportation and social service assistance, and have been housed at varying levels in order to become stabilized and receive care. Another notable success includes forming data sharing agreements among major hospital and primary care providers: NorthBay Medical Center, Kaiser Permanente, La Clinica de la Raza, Sutter Health and Community Medical Centers.
Consistent with purchasing guidelines, H&SS issued a RFP and has chosen BACS as the apparent best-evaluated Proposer. SCBH and BACS will be transitioning the existing WPC participants and perform all the requirements as stated in the WPC grant agreement including: enrollment to reach the target goal of 250 clients, improve the lower than anticipated engagement rate (estimated at 50%), develop the appropriate technical infrastructure to share and monitor client information, and the ongoing refinement of policies and procedures, particularly the referral process to mental health and substance use treatment. This is accomplished through continuous quality improvement cycles and overcoming legacy obstacles by communicating and reframing the person-centered model of health care.
H&SS will monitor outcome measures including, but not limited to, reduction of ambulatory care/emergency department visits, inpatient utilization, care coordination and management, depression remission, and supportive housing. H&SS looks forward to updating the Board of Supervisors on outcome measures in the future.
ALTERNATIVES:
The Board may choose not to approve the contract with BACS. This is not recommended because it would prevent continued operations for the WPC pilot and disrupt grant agreements between DHCS resulting in poorer health outcomes for the County’s high-risk population.
OTHER AGENCY INVOLVEMENT:
H&SS worked with the First 5 Solano Children and Families Commission, County Administrator’s Office and County Counsel to develop the request for proposals and contract with Bay Area Community Services.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION