Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with Fred Finch Youth Center for Mental Health Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Fred Finch Youth Center for mental health services, for the term of July 1, 2025 through June 30, 2027, in an amount not to exceed $3,000,000.
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BACKGROUND:
Fred Finch Youth Center (Fred Finch), a nonprofit organization, was founded in 1891 as an orphanage and has since changed its focus in response to the changing needs of the community. Headquartered in Oakland, Fred Finch offers mental health and social services to children, young adults, and their families throughout the San Francisco Bay Area. Behavioral Health and Recovery Services (BHRS) has contracted with this agency since 1999.
The Therapeutic Behavioral Services (TBS) program provides one-to-one behavioral assistance and interventions to clients under 21 years. TBS is an adjunct to an existing mental health service. Services are available to children and youth and inclusive of the caregivers. Participants learn to reduce and manage challenging behaviors and learn strategies and skills to increase the replacement behaviors that will enable children and youth to succeed in their current environment. TBS also helps participants transition to lower levels of care (e.g., move from a group to a family home).
DISCUSSION:
Fred Finch will continue to provide TBS to San Mateo County youth who are Medi-Cal beneficiaries. TBS are short-term behavioral intervention services for severely emotionally disturbed youth experiencing stressful transitions or life crises and who are at risk of placement in an institution or intensive residential program.
County Procurement has approved a waiver request for these essential services with Fred Finch, who is the County’s only current TBS provider.
BHRS is working with an actuary, recommended through the Request for Proposal process, to determine updates needed to our CalAIM rates. It is anticipated that such updates will support agencies willing to provide services under CalAIM. The actuarial work will also determine updated rates for the TBS services provided by Fred Finch.
The resolution contains the County’s standard provisions allowing amendments of the County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 80% of clients who receive services will be maintained at current or lower level of care.
PERFORMANCE MEASURES:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of clients that are maintained at current or lower level of care |
80% 53 clients |
80% 53 clients |
|
|
COMMUNITY IMPACT:
This contract positively impacts BHRS youth with Full-Scope Medi-Cal who need intensive one-to-one services in the community, out-of-county youth placed out of the county by probation and children and family services, or youth placed in the Fred Finch Short-Term Residential Therapeutic Program by the Golden Gate Regional Center due to co-occurring intellectual disability and mental health.
Most of the youth are of color, live in critically underserved communities, are diagnosed with severe mental illness, and are at risk of needing residential placement, or stepping down from a residential facility back into the community. Research shows that Black/African American, Latine, and LGBTQ+ youth face significant barriers to accessing behavioral health care. LGBTQ+ youth, in particular, are at greater risk of depression, suicidality, and substance abuse.
This contract provides intensive services that afford these youth and families the ability to successfully step down from higher acute, more costly levels of care to a community placement or to avoid being placed in a more costly level of care. This provider is committed to serving this population and supporting them to be successful while living in a community setting.
FISCAL IMPACT:
The term of the agreement is July 1, 2025 through June 30, 2027. The amount of the agreement is not to exceed $3,000,000 for the two-year term. Funds in the amount of $1,500,000 are included in the BHRS FY 2025-26 Recommended Budget. Of that amount, Federal Medi-Cal will fund $750,000 and 2011 Realignment will fund $750,000. There is no Net County Cost. The payment provisions and level of services in this agreement are essentially the same as the prior agreement. Similar arrangements will be made for future years.