To: Board of Supervisors
From: Supervisor Williams
Meeting Date: March 10, 2020
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Department Contact: |
Supervisor Williams |
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463-4441 |
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Item Type: Regular Agenda |
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Time Allocated for Item: 1 hour |
Agenda Title:
title
Discussion and Possible Action Including: 1) Direction to the Mendocino County Director of Health and Human Services to Request Aggregate Patient Outcome Data from Redwood Quality Management (RQMC) and Subcontractors Disseminate with Trends Analysis; 2) Direction to the Chief Executive Officer to Return with Options Regarding a Request for Proposal Process for Adult Mental Health Services; and 3) Direction to the Chief Executive Officer to Return with Estimate of Mental Health Funds Available for Repurpose to Meet Measure B Promises
(Continued from the February 25, 2020, Board of Supervisors Meeting)
(Sponsor: Supervisor Williams)
End
Recommended Action/Motion:
recommendation
1) Direct Mendocino County Director of Health and Human Services to request aggregate patient outcome data from Redwood Quality Management Company and subcontractors, disseminate with trends analysis; 2) Direct CEO to return with options for request for proposal process for Adult Mental Health Services; and 3) direct CEO to return with estimate of Mental Health funds available for repurpose to meet Measure B promises.
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Previous Board/Board Committee Actions:
The County of Mendocino initiated a contract with RQMC in April of 2016 Prepare the Infrastructure for the Adult System of Care during the transition from Ortner Management Group (OMG) to RQMC. Additionally, RQMC is under contract with the County for the delivery of special mental health services to children and youth under the age of twenty-five. Most recently, in July of 2019, the Board approved an $18,976,733 contract for Redwood Quality Management Company (RQMC) to provide specialty mental health care to Medi-Cal beneficiaries and the indigent on behalf of the County.
See Attachment A
Summary of Request:
County administration and the public lack data necessary to gauge outcome success of Redwood Quality Management Company and its array of subcontractors. In order to contemplate future contract terms and to develop a feedback loop for catalyzing continuous improvement, it’s important that we analyze population data and determine trends. Raw data, sanitized of confidential patient information through redaction, can be independently analyzed by county staff and the public. More eyes on the data will provoke questions, engage the public and build trust. To meet our analysis condition of satisfaction, the data must be structured sufficient to quantify the count of unduplicated persons served, duration served and cost per case, count of release plans prepared, count of times particular individuals have returned for further treatment and most importantly, how many patients are more self-sufficient due to the millions of dollars we spent. The data should be sufficient for generating histograms of varied outcome bins over 1 year, 3 years, 5 years and since program inception. Today, we lack transparency in regard to success trends relative to our past efforts, across programs and as compared to our geographic region. We are unable to say with confidence that the program has improved year over year or that we’re exceeding services of other counties per dollar spent. The request for data in and of itself does not cast doubt on the effectiveness of any of our contractor’s programs, but rather, offers us a tool for ensuring we trend towards greater success and spot areas for improvement early. Assuming data has been captured, this request should require nominal effort by our contractors and staff. If we can’t measure it, we can’t manage it. The competitive bidding process is an essential part of a County's budgeting and creates a transparent environment that is open and fair. The process allows public benefit beyond price negotiation by catalyzing discussion about conditions of satisfaction, regular progress reporting and specific service parameter expectations. The County of Mendocino Policy No 1. Section 3.2 captures the spirit of this request by specifying, "Departments shall obtain competitive bids for personal and professional services contracts (defined in section 6.0) over $25,000.” The RQMC contract has been approved by the Board of Supervisors several times since inception without engaging in the competitive bidding process. The Board is urged to request staff to return with multiple Request for Proposal options including single provider and competitive multi-provider approaches.
Mendocino County’s Measure B Mental Health Treatment Act promised facilities and services which might not be financially feasible with the revenue generated by Measure B tax. To assist in scoping projects to fit within financial realities, a timely analysis of how much, if any, of the RQMC contract could be repurposed, to ensure delivery of Measure B promises is important.
Alternative Action/Motion:
No Action.
Supervisorial District: All
vote requirement: Majority
Supplemental Information Available Online At: N/A
Fiscal Details:
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source of funding: HHSA |
budgeted in current f/y: Yes |
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current f/y cost: Nominal, Anticipated |
if no, please describe: N/A |
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annual recurring cost: N/A |
revenue agreement: N/A |
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budget clarification: Cost to analyze will be dependent upon the analysis needed. |
Agreement/Resolution/Ordinance Approved by County Counsel: N/A
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CEO Liaison: Executive Office |
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CEO Review: Choose an item. |
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CEO Comments:
FOR COB USE ONLY
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Executed By: Lindsey Dunham, Deputy Clerk I |
Final Status:Direction Given to Staff |
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Date: March 16, 2020 |
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