The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medi-Cal. EPSDT services are one hundred percent reimbursable per Medi-Cal guidelines. The contract rates for the April-June time period were lowered assuming a resumption of normal school activity. Because of the unanticipated delay with the schools returning to full capacity the provider was unable to meet the required units of service production. As we have done throughout the COVID epidemic (and allowed per State flexibility regulations) we are reverting back to the higher rates in effect from July 2020-March 2021 until the demand returns to a normalized level. There is no adverse fiscal impact with this action and the incremental cost will be offset by EPSDT/Medi-Cal revenue.  

COVID-19 is having continued negative impact on contracted providers’ ability to deliver necessary behavioral health services to Contra Costa County youth who are Medi-Cal beneficiaries eligible for entitlement services. Shelter-in-place orders have required a transition from in-person services, to remote delivery of care through use of tele-health. Since many behavioral health services to youth are school-based, the current suspension of in-person classes continues to require more outreach and engagement of children and their families in the community. While the transition to tele-health occurred fairly rapidly there are continued challenges to operations of these non-profit organizations that provide critical services to vulnerable residents of Contra Costa County. The on-going social distancing requirements to prevent disease transmission are essential but do make delivery of critical services extremely challenging and at times not possible.   
  
On July 9, 2019, the Board of Supervisors approved Contract #74–218–21 with Desarrollo Familiar, Inc., in an amount not to exceed $204,933 for the provision of community based mental health services for children and their families in West Contra Costa County for the period from January 1, 2021 through June 30, 2021. This Agreement includes a six-month automatic extension through December 31, 2021, in an amount not to exceed $204,933. Expected program outcomes include an increase in positive social and emotional development as measured by the Child and Adolescent Functional Assessment Scale (CAFAS).  
  
Approval of Amendment Agreement #74–218–22 will allow the rate adjustments, applicable to the contract and automatic extension, to provide cash flow and budget predictability and allow the services to continue through December 31, 2021.

If this amendment is not approved, children in West Contra Costa County may experience reduced or discontinued mental health services and require higher levels of service.

This program supports the following Board of Supervisors’ community outcomes: 1, 4 & 5.