TO: Board of Supervisors
FROM: Jennifer Yasumoto, Health & Human Services Agency
REPORT BY: Gaby Angeles, Staff Services Analyst II
SUBJECT: Amendment No. 1 to Agreement No. 200105B with Stanford Youth Solutions, Inc. (Early and Periodic Screening, Diagnosis and Treatment Services)
RECOMMENDATION
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Director of Health and Human Services Agency (HHSA) requests approval of and authorization for the Chair to sign Amendment No. 1 to Agreement No. 200105B with Stanford Youth Solutions, Inc., dba Stanford Sierra Youth and Families, to increase the annual contract maximum to $1,100,000 for the term July 1, 2022, through June 30, 2023, and each subsequent automatic renewal thereafter, and to incorporate revisions to Exhibits A and B, to provide Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mental health services for children and youth in schools and in the community.
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EXECUTIVE SUMMARY
Approval of today’s requested action will allow for a contract maximum increase of $746,090 for a new annual maximum of $1,100,000 for the provision of newly added Therapeutic Behavioral Services (TBS), update rates, and revise language in Exhibits A and B to allow the provider to begin administering TBS alongside their already active specialty mental health services, as well as incorporate recently mandated Medical Necessity requirements that providers will have to abide by when serving children and youth due to the California Advancing and Innovating Medi-Cal (CalAIM) plan.
FISCAL & STRATEGIC PLAN IMPACT
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Is there a Fiscal Impact? |
Yes |
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Is it currently budgeted? |
Yes |
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Where is it budgeted? |
Health & Human Services Agency, Mental Health Division |
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Is it Mandatory or Discretionary? |
Mandatory |
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Is the general fund affected? |
No |
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Future fiscal impact: |
This agreement contains a provision for automatic annual renewal. Appropriations are included in the requested FY 2022-2023 budget and future fiscal years will be budgeted accordingly. |
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Consequences if not approved: |
If this contract is not approved much-needed mental health services in Napa Schools and community settings will not be provided. |
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County Strategic Plan pillar addressed: |
Healthy, Safe, and Welcoming Place to Live, Work, and Visit |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.
BACKGROUND AND DISCUSSION
Formerly known as Stanford Youth Solutions, Stanford Sierra Youth and Families (SSYAF), is a child and family mental health provider of intense individualized specialty mental health programs to children and families in difficult situations. SSYAF has provided contracted services to Napa County youth and children for over 3 years. Most of their services have been delivered through co-location at Napa County Office of Education (NCOE), various Napa elementary schools, and select community based mental health service locations. In the fall of 2021, this provider was awarded a renewed agreement through a competitive procurement Request for Proposal (RFP) process. The result of this award increased the provider’s contract maximum from $353,910 to $1,100,000. The amount of the increase was based on the projected utilization of services that SSYAF could do in a year.
The newly awarded agreement will include additional services to the contractor’s scope of work such as: TBS, enhanced school-based services throughout the county, and the utilization of other community based settings to deliver services as needed. It should be noted that SSYAF is taking over as Napa County’s primary and only TBS provider. With the larger contract maximum, SSYAF is expected to not only expand their service delivery area throughout the entire Napa Valley but they will also administer additional service modes to reach more children and youth in need. A new rate for the TBS services at $3.09/min has also been added to the agreement. All other services rates have been updated from $3.88/min to $3.84/min.
Lastly, in addition to scope of work enhancements, the renewed agreement will incorporate recently mandated Medical Necessity requirements that providers will have to abide by when serving children and youth due to the CalAIM plan, which is a multi-year initiative by the State of Health Care Services (DHCS) to improve the quality of health outcomes of Medi-Cal beneficiaries. There are two major changes to what was previously referred to as “Medical Necessity Criteria.” One of these changes is that an “included diagnosis” is no longer required to bill for services. The other major change is that CalAIM now breaks down what was previously known as “Medical Necessity Criteria” into two parts: “Access to Specialty Mental Health Services” and “Medical Necessity.” The new criteria to Access services refers to an individual’s eligibility for Specialty Mental Health Services (SMHS). Medical Necessity now refers to determining which services are appropriate for the client to receive, and includes determining if the client requires the level of service provided by provider or if the client would be better served in another level of care (e.g. mild-to-moderate services). In other words, the Access Criteria gets the individual in the door to receive SMHS, and Medical Necessity will be used to determine what types and level of service the client should receive. Both of these changes require updated diagnostic and procedural expectations that accompany the new guidelines have been clearly outlined within the narrative of the renewed agreement.
Stanford Youth Solutions, Inc., is not a local vendor.