By OPEN MINDS Circle
The County of San Diego, California is rebidding its county-wide behavioral health and primary care integration services contract. The current contractor, Community Clinics Health Network, dba Health Quality Partners of Southern California, has held the contract since December 2006. The current contract is valued at slightly more than $1 million per year. Funding for the contract services is through the county’s Mental Health Services Act (MHSA) and realignment funding.
The current contractor provides services and treatment to adults age 18 and older who have behavioral health problems. The services are provided in a primary care setting. Consumers receive mental health assessment, dual diagnosis screening information, brief mental health services, and linkages to services as needed. During fiscal year 2019-2020, the program served 889 unduplicated consumers.
Over the past 10 years, the contractor has helped ensure that the majority of federally qualified health centers (FQHCs) in the county have primary care integration programs that provide universal screening, evidenced based stepwise interventions and referral to specialty behavioral health when appropriate. The RFP noted that although primary care clinics have established integrated care programs, people with behavioral health conditions are still often disconnected from routine primary care. The updated primary care integration RFP seeks to help community-based provider organizations advance their primary care integration programs and their care management capacity to increase access to services and care coordination for consumers with behavioral health disorders.
The request for proposals (RFP 11215) to rebid the services was released on September 28, 2021. Proposals are due by October 29, 2021. The contract term is anticipated to have an initial six-month base period, followed by four one-year renewal options. The estimated value for the maximum 4.5-year period is between $6.5 million and $7 million. Payment is structured as cost-reimbursement based on monthly invoices. The contractor and/or subcontractors will seek reimbursement for direct services from Medicare, Medicaid, or private insurers for services that are billable and not covered under this contract.
Bidders must submit one proposal that encompasses the key services in four different regions of the county. The bidder will be responsible for managing and coordinating the implementation of a collaborative care model for adults ages 18 and older at contractor-identified primary care clinics throughout the county.
The selected contractor will subcontract or establish Memoranda of Agreements (MOAs) with the following: at least four primary care sites, four county-contracted mental health outpatient clinics, and four addiction treatment provider organizations. At least one primary care site must be in each of the following county geographic regions: North, Central, East, and South County. At the mental health clinics, they will help coordinate care and transitions in care from the clinic to the primary care professional and vice versa. At the addiction treatment provider organizations, they will help coordinate care between the primary care provider organization which may also be providing medication assisted treatment (MAT) and with the addiction treatment provider organization.
The MHSA funding shall cover the cost of the following: Integrated Health Care Coordinators and Peer Support Specialists, behavioral health related medication and lab costs for up to four months as needed for unfunded consumers, psychiatric and addiction consultants, trainings, and technical assistance; and the cost of same day mental health or substance use disorder services at FQHCs.
Services will be provided to people identified as needing behavioral health interventions based on screenings at the primary care sites. The services will be provided within the scope of the contract for people without behavioral health care coverage or those covered by California Medicaid. For those without behavioral health coverage, the contractor will determine whether the consumers are eligible for insurance coverage and if so, support them in attaining such coverage. Unfunded consumers can be provided with behavioral health-related medications and medication management services through the primary clinic for up to four months when deemed medically necessary and when there is no other funding source available.
The contractor will collaborate with primary care provider organizations to increase availability of additional MAT prescribers and to provide additional support to MAT prescribers. Integrated Health Care Coordinators and Peer Support Specialists shall provide addiction disorder coordination of care services to consumers receiving MAT from a primary care provider organization. The contractor shall provide required trainings and needed resources to become a MAT prescriber for interested professionals at various primary care sites. The contractor will provide additional trainings on MAT education and on the prevention of opioid misuse and related harms to primary care professionals.
The contractor will establish and implement psychiatric and addiction consultation and consumer support services for primary care and obstetric professionals who serve adults with Medi-Cal or adults who are uninsured and reside in the county. The model will enhance primary care and obstetric professional’s competence, confidence, and capacity to identify and treat uncomplicated behavioral health issues in a primary care/medical setting. It will increase and improve identification of behavioral health issues, including suicide risk in underserved populations being seen in primary care/medical settings. The contractor will provide education, referrals and linkages for consumers seeking behavioral health services.
The contract responsibilities include leadership collaboration and technical assistance for professionals at primary care sites. The goal is to help primary care provider organizations make process and cultural changes. Virtual trainings and technical assistance will be provided monthly. These sessions will have a basis in chronic illness management and population health with a behavioral health focus and techniques for improved integration strategies. The contractor will also facilitate an annual “Integration Summit” for primary care, mental health, and addiction disorder professionals to promote collaboration and sharing knowledge about integrated services. The summit shall provide continuing education opportunities for attendees of all disciplines.
For more information, contact:
- Tricia McEwen, Purchasing and Contracting, San Diego County, 5560 Overland Avenue, Suite 270, San Diego, California 92123; 858-505-6339; Fax: 858-715-6453; Email: tricia.mcewen@sdcounty.ca.gov; Website: https://www.sandiegocounty.gov/
- Sarah Sweeney, Communications Officer, San Diego County, 5560 Overland Avenue, Suite 270, San Diego, California 92123; 619-685-2522; Email: Sarah.Sweeney@sdcounty.ca.gov; Website: https://www.sandiegocounty.gov/