Fremont City Council Meeting: 06/14/22 07:00 PM
3300 Capitol Avenue Div/Dept: Human Services Department Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
STAFF REPORT (ID # 4634) DOC ID: 4634 C
Updated: 6/9/2022 11:00 AM by Alberto Quintanilla C Page 1 MENTAL HEALTH SERVICES AGREEMENTS - Authorization to Contract with Alameda County Behavioral Health and La Familia to provide Mental Health Services; and Appropriate Additional Funds and Making Findings of CEQA Exemption
Contact Persons:
Name: Annie Bailey Suzanne Shenfil
Title: Youth and Family Services
Administrator
Director
Div/Dept: Human Services Department Human Services Department Phone: 510-574-2111 510-574-2051
E-Mail: [email protected] [email protected]
Executive Summary: Staff recommends that the City of Fremont enter into two agreements not to exceed $2,449,711, including: (1) an agreement with Alameda County Behavioral Health (ACBH), in the amount of $2,194,260 for the Human Services Department’s Youth and Family Services (YFS) Division, Aging and Family Services (AFS) Division, and Family Resource Center (FRC) Division to provide mental health services; and (2) an agreement with LaFamilia, in the amount of $255,451, for FRC division to provide mental health counseling services, on a fee for service basis, as part of a multi-disciplinary Working Wellness Program, to adults receiving Cal WORKs benefits, who are enrolled in the Welfare to Work program and facing mental health challenges transitioning to work.
In the proposed FY 2022/23 Operating Budget, an accompanying item on this agenda, staff has recommended the City Council appropriate $2,273,690 in anticipation of these two contracts. Staff now anticipates the actual contract amounts will be higher and therefore recommends the City Council increase the revenue estimate and appropriate an additional $176,021 to equal the revised two-contract total of $2,449,711.
BACKGROUND:
ACBH Mental Health Services Contract
The YFS Division has received Medi-Cal reimbursement from ACBH for eligible mental health services provided to children and adults through its various programs since FY 1999/00.
YFS provides services to children with “full-scope Medi-Cal” (i.e., complete Medi-Cal coverage) that are funded through EPSDT, which is the joint county, state, and federal Medicaid reimbursement mechanism for services provided to children. EPSDT provides reimbursement for services based on actual costs up to the maximum allowed, which requires the development of interim reimbursement rates and a final cost settlement each year. The FY 2022/23 contract initially establishes interim reimbursement rates, which enables the City to claim reimbursement for services on a monthly basis. Any differences between the City’s actual costs and the reimbursement paid are settled through the end-of- year cost settlement process.
Staff Report (ID # 4634) Meeting of June 14, 2022
Updated: 6/9/2022 11:00 AM by Alberto Quintanilla C Page 2 The AFS Division has provided mental health services to isolated seniors in their homes since 2008. This portion of the agreement is funded through Mental Health Services Act (MHSA), which was designed to expand and transform California’s county mental health services system. MHSA provides supplemental funding for mental health services through an additional one percent tax on individual taxable incomes of $1 million or more.
Shortly after passage of MHSA, a county-wide planning process identified a need for geriatric mental health services, specifically targeted at seniors isolated in their homes and unable to access services due to transportation and physical/mental health barriers. As a result of this identified need, the City developed the Mobile Mental Health Team to provide geriatric mental health services in southern Alameda County and thereby improve the mental health of seniors 60 years of age and older, who are 1) isolated and therefore unable to access clinic services, and 2) unable to manage independence due to physical/mental disabilities. These seniors are often at risk of institutionalization, nursing home care, hospitalization, repeated 911 calls, and emergency room visits. AFS has added a Recovery & Resiliency (R&R) step-down program and a peer support program for LGBT+ older adults.
The FRC and YFS Divisions will continue to provide Adult Outpatient Therapy services to adults with moderate to severe mental health issues. Services will be provided by licensed staff, Associate Social Workers and graduate clinical interns.
La Familia Contract
Since 2001, the FRC Division has collaborated with Alameda County to form a multi- disciplinary and multi-agency Family Service Team (FST) for clients with multiple issues, who are receiving public assistance through CalWORKs. The City has provided mental health and wrap-around services, helping participants move from welfare to work.
The county re-bid these contracts for FY 2019/20 and required providers to serve a much larger geographic area of the county which included the Tri-Cities, the Tri-Valley area, Hayward and San Leandro. Together, the City and La Familia submitted a successful application under a new program name, Working Wellness Program, with La Familia as the lead agency and the City as a subcontractor, to provide these services to an expanded south county group of CalWORKs participants.
Staff Report (ID # 4634) Meeting of June 14, 2022
Updated: 6/9/2022 11:00 AM by Alberto Quintanilla C Page 3 DISCUSSION/ANALYSIS:
The YFS Division, in FY 2022/23, will provide approximately 6,300 service hours in the following categories:
• Healthy Choices School-Site Counseling Services at Fremont school sites; • The Infant Toddler Program, which serves families with children who are five years old and younger. The program includes the Early Connections project, which includes a full-time Family Partner that promotes family-driven mental health care for children;
• The Youth Service Center, which serves youth with mental health needs and their families;
• The Truancy Intervention and Probation Youth Program, which serves pre-delinquent and delinquent youth and their families; and
• Outpatient Adult Mental Health brief therapy services (the AFS and FRC division will provide additional support in providing these services).
The AFS Senior Mobile Mental Health Program provides mental health services to a minimum of 55 clients a year in order to improve their ability to live safely in the community. An additional 10 clients are supported in Recovery and Resiliency program, a ‘step down’ program that offers a transition to Senior Mobile Mental Health Program clients.
Together these two programs will provide 1,507 hours of outpatient services, which will include 500 hours of medication support, and an additional 176 hours of outreach and engagement. The team is multi-disciplinary, consisting of a part-time psychiatrist, part – time physicians’ assistant, licensed counselor and clinical supervisor. The team visits isolated seniors in their own homes to diagnose their mental status and assess their need for mental health services. The treatment team works with the seniors, and where possible their family, to develop a treatment plan that may include prescribing and monitoring psychotropic medications, providing counseling, and referring seniors to other resources as needed. The Mobile Mental Health team works closely with the City’s senior case management program and Adult Protective Services, and coordinates home delivered meals and inpatient hospitalization, if needed.
In addition, AFS will provide a Mental Health Peer Coaching program to LGBTQ+ seniors.
The peer model was originally developed to reduce loneliness and increase self-efficacy among older adults (at least 60+) with severe to moderate mental illness. The model had positive outcomes that improved both coaches and the peer to have emotional, mental and physical stability with supportive environment. The peer support program was expanded to target LGBTQ+ population in FY 2016/17. The program includes process of engaging, empathetic listening, encouraging and educating LGBTQ+ older adults around enhancing wellness and preventing isolation and reducing the stigma often experienced by LGBT+ older adults.
The FRC Division assists clients who are on CalWORKs in removing barriers to employment. The FRC Working Wellness program provides a coordinated and integrated system of support for clients and their families, which may include health, substance abuse and mental health services, as well as educational and job search assistance, aimed at helping them to exit the CalWORKs system. The model invites the Cal WORKs participant to be an active member of their treatment team. This program utilizes the IPS model of Employment Services, provided by IPS staff from La Familia. In FY 2022/23, the FRC will Staff Report (ID # 4634) Meeting of June 14, 2022
Updated: 6/9/2022 11:00 AM by Alberto Quintanilla C Page 4 provide approximately 903 hours of counseling and 267 hours of case management services to CalWORKs clients working with the FST.
The YFS and FRC divisions will provide 936 hours of service to 30 unduplicated clients in the Adult Outpatient Therapy program, referred by ACCESS.
FISCAL IMPACT: Funding under these agreements offsets the costs of full-time mental health professionals, clinical supervision, clerical support costs and City overhead expenses.
While the reimbursement rates for the fee-for-service portions of the agreements may vary between the contracts and cost settlement, the total maximum amount for which the City can be reimbursed remains at $2,449,711. As part of the FY 2022/23 Operating Budget, staff anticipated these program contracts would total $2,273,690. Staff is requesting a total of $176,021 in additional appropriations in three funds to match the actual total of the two contracts.
FY 2022/23 Additional Appropriation Request
Division Fund
Original
Anticipated
Revenue
Contract
Total
Additional
Appropriation
Request
AFS 104 795,068 833,626 38,558
YFS 170 1,246,394 1,360,634 114,240
ACBH Contract: $2,041,462 $2,194,260 $152,798
FRC LaFamila Contract: 172 $232,228 255,451 23,223 2,273,690 2,449,711 $176,021
ENVIRONMENTAL REVIEW: This action is exempt from and is not subject to review under the California Environmental Quality Act (CEQA) pursuant to, without limitation, CEQA Guidelines section 15061 and/or 15378(b)(2) and/or (5) as the activities contemplated are organizational activities of government that will not result in direct or indirect physical changes in the environment, each of the foregoing providing a separate and independent basis for CEQA exemption. .
ATTACHMENTS: None.
RECOMMENDATION: By motion:
1. Authorize the City Manager or her designees to execute two FY 2022/23 agreements totaling $2,449,711 including:
a. an agreement with Alameda County Behavioral Health (ACBH), in the amount of $2,194,260 to provide mental health services;
b. an agreement with LaFamilia, in the amount of $255,451 to provide mental health counseling services to adults transitioning to work.
2. Appropriate an additional $38,557 in the ACBH Aging and Family Services Fund (Fund 104), an additional $114,240 in the ACBH Youth and Family Services Fund (Fund 170), and an additional $23,223 in the ACBH FRC Behavioral Health Fund (Fund 172).