Fremont City Council Meeting: 07/15/25 07:00 PM
3300 Capitol Avenue Div/Dept: Human Services Department Fremont, CA 94538 Category: Agreements and Contracts
SCHEDULED
Sponsors:
COUNCIL STAFF REPORT (ID # 5495) DOC ID: 5495
Updated: 7/11/2025 9:20 AM by Dina Lewis Page 1
MENTAL HEALTH SERVICES AGREEMENTS - Authorize the City Manager to Execute Agreements with Alameda County Behavioral Health and La Familia to provide Mental Health Services; Appropriation Actions; and Making Findings of CEQA Exemption
Contact Persons:
Name: Annie Bailey Arquimides Caldera
Title: Youth and Family Services
Administrator
Human Services Director
Div/Dept: Human Services Department Human Services Department Phone: 510-574-2111 510-574-2056
E-Mail: [email protected] [email protected]
Executive Summary: Staff recommends that the City Council authorize the City Manager to enter into two agreements: (1) an agreement with Alameda County Behavioral Health (ACBH) in the amount of $2,874,480 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 increase its capacity to provide such services; and (2) an agreement with La Familia in the amount of $267,888 for the FRC Division to provide mental health counseling services, as part of a multi - disciplinary Working Wellness Program. Staff also recommends appropriating an additional $5,845 to mental health service budget accounts to cover the total amount of the ACBH agreement.
BACKGROUND:
ACBH Mental Health Services Agreement
The Human Services Department has provided Medi-Cal funded services to South Alameda County residents for many years, including mental health services, substance use disorder services, and Targeted Case Management services.
Medi-Cal is California’s Medicaid health care program. Medi-Cal pays for services for children and adults with limited income and resources. Currently, the Medi-Cal program is undergoing a transformative system change, moving away from the state funding of individual services to the California Advancing and Innovating Medi-Cal (CalAIM) program, with the goals of:
a. Improving population health using a whole person care model and social determinants of health,
b. Reducing complexity and variation, and increasing flexibility of services across Medi-Cal, and
c. Improving quality outcomes, reducing health disparities, and modernizing systems through value-based initiatives and payment reform.
In FY 2025/26, as part of CalAIM, ACBH intends to change the payment model for some behavioral health contracts. For many years, ACBH provided reimbursement for Early Council Staff Report (ID # 5495) Meeting of July 15, 2025 Updated: 7/11/2025 9:20 AM by Dina Lewis Page 2
Periodic Screening Diagnosis and Treatment (EPSDT) services based on the City’s actual costs up to a maximum allowed rate, which required the development of interim reimbursement rates and a final cost settlement each year. Under the new fee for service model, the City will no longer have to go through a cost settlement process and will instead be paid a negotiated rate regardless of its costs.
The YFS Division: The YFS has received Medi-Cal reimbursement from ACBH for eligible mental health services since FY 1999/2000. 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.
The AFS Division: The AFS Division has provided mental health services to isolated seniors in their homes since 2008. This portion of the agreement is partially funded through the Behavioral Health Services Action (BHSA), which is replacing the Mental Health Services Act (MHSA). Both BHSA and MHSA provide supplemental funding for mental health services through an additional one percent tax on individual taxable incomes of $1 million or more.
The Senior Mobile Mental Health Team provides geriatric mental health services in southern Alameda County for 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 subsequently added a Recovery & Resiliency (R&R) step-down program, a peer support program for LGBT+ older adults, and an Asian American and Pacific Islander (AAPI) community support program.
The FRC, AFS, and YFS Divisions also provide Adult Outpatient Therapy services to adults with moderate to severe mental health issues. Services are provided by licensed staff, Associate Social Workers, and graduate clinical interns.
La Familia Mental Health Services Agreement
The FRC Division has collaborated with Alameda County since 2001 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.
In 2019, Alameda County re-bid this contract 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. The City and La Familia submitted a successful joint application to provide these services to an expanded South Alameda County group of CalWORKs participants under a new program name, the Working Wellness Program, with La Familia serving as the lead agency and the City as a subcontractor.
DISCUSSION/ANALYSIS:
YFS Division: In FY 2025/26, the YFS Division, will provide approximately 7,669 service hours in the following categories:
Council Staff Report (ID # 5495) Meeting of July 15, 2025 Updated: 7/11/2025 9:20 AM by Dina Lewis Page 3
• 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. This program also 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;
• Outpatient Adult Mental Health brief therapy services (the AFS and FRC divisions will provide additional support in providing these services); and • Intensive Care Coordination (ICC) for mental health clients. This is a form of Targeted Case Management (TCM) for youth.
AFS Division: In FY 2025/26, the AFS Division will provide mental health services to a minimum of 200 clients a year to improve their ability to live safely in the community. The programs will provide 2,081 hours of outpatient services, which will include 250 hours of medication support, and an additional 850 hours of outreach and engagement. The team is multi-disciplinary, consisting of a part-time psychiatrist, part–time physicians’ assistant, licensed counselors, human services specialist, and a clinical supervisor. Outreach and services provision will happen in community settings, such as the Age Well Center s and senior housing. The team also 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 provides a Mental Health Peer Coaching program to LGBTQ+ seniors (at least 60+). The program includes outreach, empathetic listening, support, and education to enhance wellness, prevent isolation and reduce the stigma often experienced by LGBT+ older adults.
In FY 2025/26, the program will also provide support services to over 300 AAPI older adults , a population that has been underserved in mental health interventions. This program conducts community-based classes around wellness at locations where older adults naturally congregate, such as senior housing facilities and faith-based agencies.
The FRC Division: In FY 2025/26, the FRC Division will continue to assist clients who are on CalWORKs in removing barriers to employment. The FRC and La Familia’s collaborative 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 clients 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 Individual Placement and Support (IPS) model of Employment Services, provided by IPS staff from La Familia. In FY 2025/26, the FRC will provide approximately 766 hours of service to 26 unduplicated clients.
Council Staff Report (ID # 5495) Meeting of July 15, 2025 Updated: 7/11/2025 9:20 AM by Dina Lewis Page 4
The YFS, FRC and AFS divisions will provide 976 hours of service to 35 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.
There is no impact to the General Fund. While the reimbursement rates for the fee-for-service portions of the agreements may vary, the total not to exceed amount for the ACBH agreement is $2,874,480, and the total not-to-exceed amount for the La Familia agreement amount is $267,888.
Funding for these programs was included in the City’s FY 2025/26 adopted budget.
However, as the final amounts for these agreements are slightly higher than the budget estimates, staff is recommending the City Council appropriate an additional $3,000 to the AFS Mobile Mental Health account of the ACBHCS AFS Behavioral Health Fund (Fund 104), and an additional $2,845 to Mental Health – EPSDT account of the ACBHCS YFS Behavioral Health Fund (Fund 170).
ENVIRONMENTAL REVIEW: The proposed actions are exempt from and not subject to review under the California Environmental Quality Act (CEQA) because, without limitation, it is not a “project” as that term is defined under CEQA Guidelines Sections 15378(b)(2), (4) and/or (5) and because it can be seen with certainty that there is no possibility that the activity may have a significant effect on the environment per CEQA Guidelines Section 15061(b)(3), each of the foregoing providing a separate and independent basis for CEQA exemption.
ATTACHMENTS: None.
RECOMMENDATIONS: Approval of the following related to the delivery of mental health services:
1. Authorize the City Manager, or designee, to execute a Mental Health Services Agreement with Alameda County Behavioral Health (ACBH), in the amount of $2,874,480.
2. Authorize the City Manager, or designee, to execute a Mental Health Services Agreement with La Familia, in the amount of $267,888.
3. Appropriate an additional $3,000 in Fund 104 and $2,845 in Fund 170 to cover the updated not-to-exceed amounts of the proposed Mental Health Services Agreements.