title
APPROVE A PROFESSIONAL SERVICES AGREEMENT WITH CARE SOLACE, INC. TO PROVIDE SOCIAL AND MENTAL HEALTH CARE COORDINATION SERVICES UTILIZING FUNDS RECEIVED THROUGH THE NATIONAL OPIOID SETTLEMENT AGREEMENTS
recommended action
RECOMMENDATION
It is recommended that the City Council approve a motion to:
1. Approve findings pursuant to Stockton Municipal Code section 3.68.070 to justify and support an exception to the competitive bidding process.
2. Award a Professional Services Agreement to Care Solace, Inc. of Cardiff, CA in the Not-to-Exceed amount of $855,000 for a three-year term to provide social and mental health care coordination services utilizing funds received through the National Opioid Settlement Agreements.
It is also recommended that the City Manager be authorized to take appropriate actions to carry out the purpose and intent of this motion.
body
Summary
California has joined multiple national lawsuits against manufacturers, distributors, and other entities responsible for aiding the opioid epidemic. As a result, the City of Stockton has received funds from opioid judgments and anticipates receiving funds from future judgments.
By Resolution 2023-11-14-1501, the City Council approved to accept and appropriate all funds allocated to the City of Stockton under the Opioid Settlement Agreement (OSA), and to authorize the City Manager to accept and appropriate all funds allocated to the City under the OSA.
The City intends to contract with Care Solace, Inc (“Contractor”) for a three-year term to utilize a portion of funding received by the City of Stockton under the California Opioid Settlements to provide services to the community. Through this additional strategy that expands usage of OSA funds, the Contractor will serve as a central hub of care for the provision of social and mental health care coordination services to Stockton residents.
DISCUSSION
Background
California has joined multiple national lawsuits against manufacturers, distributors, and other entities responsible for aiding the opioid epidemic. As a result, the City of Stockton began to receive funds from opioid judgments in 2022, and it is anticipated that allocations from future settlements will continue to be received in annual distributions for the next five to twelve years, depending on settlement. Each state’s share of the funding has been determined by agreement among the states using a formula that considers the impact of the opioid crisis on the state - the number of overdose deaths, the number of residents with Substance Use Disorder (SUD), and the number of opioids prescribed - along with population of the state.
Funds allocated to the City of Stockton from California’s opioid settlements are distributed into one of two sub-funds: 1) Abatement Account Funds, to use for future opioid remediation, and 2) California Subdivision Funds, to use for future opioid remediation activities and to reimburse past opioid-related expenses.
California jurisdictions receiving OSA allocations must utilize funds for substance use prevention, intervention, harm reduction, treatment and recovery services in communities. Abatement Accounts funding must be used for responses that qualify under California’s High Impact Abatement Activities (HIAA), as defined by the California Department of Health Care Services (DHCS). Within this HIAA List of Opioid Remediation Uses are both “Core Strategies” and “Approved Uses” (Attachment A). In its role as a Plaintiff Subdivision, the City of Stockton must utilize California Subdivision Accounts to fund future opioid remediation projects and reimburse past opioid-related expenses, as well as ensure compliance with annual reporting requirements to DHCS.
Present Situation
In November 2023, City Council adopted Resolution 2023-11-14-1501 (Attachment B) to accept and appropriate all funds allocated to the City under the OSA, to authorize the City Manager to accept and appropriate all funds allocated to the City under the OSA, and to award a Professional Services Agreement to Community Medical Centers (CMC) of Stockton to utilize funds to remediate and provide activities that reduce the effects of the opioid epidemic in communities. The City’s agreement with CMC was the first anticipated initiative for usage of OSA funds, with the intent to explore further allowable uses of funds with additional community partners.
In order to leverage the strategic usage of OSA funds, the City intends to contract with Care Solace, Inc. for a three-year term in the not-to-exceed amount of $855,000. Care Solace will serve as a “Central Hub of Care” to provide social and mental health care coordination services to Stockton residents.
Care Solace provides timely connections to verified mental health providers and local social services, expands on existing programs, and bridges the gaps for needs that exceed the scope of those services. Serving as a coordinated point of entry to mental health and social services, Care Solace supports the entire Stockton ecosystem from first responders to crisis centers, to social workers, to courts and jails, and to all residents. Through a tech-enabled human approach, Care Solace will ensure that individuals receive equitable access to reliable, ethical, and high-quality mental health care, regardless of coverage, including private insurance, Employee Assistance Program (EAP), Medicaid, and sliding scale options for those without insurance. Care Solace’s care coordination will help bridge the gap to behavioral health services for individuals in even the most vulnerable communities.
Care Solace’s three main proprietary services - Care Loop, Care Match, and Care Companions - will amplify the City’s current initiatives and services while filling gaps and offering insights through its proposed Scope of Services (Attachment C). The Contractor’s Provider Database offers City residents and agencies access to more than 473,000 verified mental health providers, including those offering advanced pathways to care. Providers are geocoded, so an individual can select a local provider for in-person sessions if that is the preference. Selection filters also include language, ethnicity, age, specialization and more. All services are confidential and accessible 24/7/365, can be accessed via phone or internet, and do not require any special equipment or access speed.
This proposed project aligns with DHCS requirements for using opioid abatement funding, as shown in the HIAA / Attachment A:
1. Approved Uses: CONNECT PEOPLE WHO NEED HELP TO THE HELP THEY NEED (CONNECTIONS TO CARE)
Provide connections to care for people who have - or are at risk of developing - Opioid Use Disorder (OUD) and any co-occurring Substance Use Disorder / Mental Health conditions (SUD/MH) through evidence-based or evidence-informed programs or strategies that may include, but are not limited to, those that:
i. Support centralized call centers that provide information and connections to appropriate services and supports for persons with OUD and any co-occurring SUD/MH conditions.
ii. Purchase automated versions of Screening, Brief Intervention, and Referral to Treatment (SBIRT) services and support ongoing costs of the technology.
iii. Expand warm hand-off services to transition to recovery services.
Care Solace delivers monthly impact reports including Key Performance Indicators (KPIs) through a variety of data points, as well as live Impact Reporting via an administrative dashboard, allowing the City team secure access to real-time data on community mental health and KPIs. Additional data can be requested, such as client satisfaction and feedback on Care Solace customer services from users who utilize the Care Companion services. Care Solace’s efforts underscore the City’s Strategic Plan by leveraging data analytics to provide transparency and guide evidence-informed decision-making.
Care Solace’s goal is to provide a single interface to mental health services and thereby ensure that communities can easily and equitably access mental health care and wraparound social services, without being limited by resources or fragmentation. It is the only service that aggregates hundreds of thousands of clinical therapy and telehealth resources as well as insurance information into one database, to streamline care coordination and reduce time and attrition in accessing mental health care. As the only U.S.-based mental health care coordination service with proprietary software, a database of more than 473,000 health care providers and warm-handoff processes, the Contractor uniquely qualifies as a Single Available Source for procurement.
Community Medical Centers, as a trusted and informed stakeholder, and as the City’s principal mental and behavioral health partner, will assist in supporting deliverables of ongoing care coordination and services. Examples of collaboration with CMC include initial onboarding meetings, ongoing training sessions, as well as support with situation assessments, identification of appropriate partners, acceptance of QR code Warm Handoffs® and follow-through with client care.
Mental health affects everyone - nearly half of the population will experience a mental health concern during the course of each lifetime. According to the report, Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health developed by SAMHSA (Substance Abuse and Mental Health Services Administration):
- In 2021, 18.8 percent of adults aged 18 or older (or 46.5 million people) received any of the following mental health services in the past year: inpatient or outpatient mental health services, prescription medication for a mental health issue, or virtual (i.e. telehealth) services.
According to San Joaquin County Behavioral Health Services (SJBHS):
- About four percent of Americans - across all income, geographic and ethnic backgrounds - live with a chronic, severe and disabling mental illness.
- Approximately 21 percent of adolescents have had a mental health disorder by the age of 18.
Implementation of the Care Solace Central Hub of Care will provide another powerful tool in Stockton’s toolkit to connect residents with licensed behavioral health care providers and social services, and will further efforts to impact mental health and community well-being through a dedicated funding source.
Findings
Pursuant to Stockton Municipal Code section 3.68.070, Council may approve findings which support and justify an exception to the competitive bidding process. The following findings support such an exception:
1. The City lacks the capacity and resources to provide Stockton residents with unlimited access to social and mental health care coordination services through a confidential self-service portal.
2. Use of the Single Available Source procurement is appropriate for this Professional Services Agreement because the Contractor possesses proprietary software, developed and distributed exclusively by Care Solace, Inc., that provides a single interface to social and mental health services.
3. Contractor offers the only full-service mental health care and social services coordination system available to municipalities. The system currently supports over 18 million individuals on the platform, and there is no competitive alternative available on the market which fulfills the same purpose and function.
FINANCIAL SUMMARY
Annual pricing for the City of Stockton is based on a fee of $1.00 per resident/per year. This rate is based on a population of 285,500 residents who are not already covered by Care Solace services through an existing contract with Stockton Unified School District for children and their families (a population of 36,500).
There is sufficient funding in the Opioid Settlement Agreements revenue accounts to award a Professional Services Agreement (Attachment D) to Care Solace, Inc. in the not-to-exceed amount of $855,000 for a term of three years, to provide social services and mental health care coordination services to Stockton residents. There is no impact to the General Fund or any other non-restricted funds from this action.
Attachment A - Final Settlement Agreement: List of Opioid Remediation Uses
Attachment B - Approved Resolution 2023-11-14-1501
Attachment C - Care Solace, Inc. Proposed Scope of Services
Attachment D - Care Solace, Inc. Professional Services Agreement