To: Board of Supervisors of Sonoma County
Department or Agency Name(s): Department of Health Services, Human Services Department, Community Development Commission, Probation Department, Child Support Services Department, Office of the District Attorney, Sheriff’s Office, and Public Defender
Staff Name and Phone Number: Tina Rivera, 707-565-7876; Angela Struckmann; Rhonda Coffman; Vanessa Fuchs; Janeene de Martinez; Carla Rodriguez; Eddie Engram; Brian Morris
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
ACCESS Sonoma Safety Net Initiative - IBM Agreement
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to accept revenue from the Substance Abuse & Mental Health Services Administration (SAMHSA) within the U.S. Department of Health & Human Services (HHS) in the amount of $1,600,000 as a grant award for the County’s ACCESS-Sonoma program.
B) Authorize the Director of Health Services, or designee, to execute Addendum 6 to the Statement of Work with International Business Machines (IBM) Corporation’s contract for both (1) the software automation of the current Mental Health Diversion cohort program, (2) 2-1-1 Data Extract, and (3) the development of a Transitional Age Youth (TAY) cohort program within the ACCESS Sonoma Data Hub Project, in an amount not-to-exceed $1,600,000 through June 30, 2023.
C) Adopt a resolution authorizing budgetary adjustments to the Fiscal Year 2022-2023 adopted budget to reflect increased revenue and expense appropriations of $1,600,000. (4/5th vote required)
(4/5th Vote Required)
end
Executive Summary:
On March 23, 2018, the Sonoma County Department of Health Services (hereinafter, “DHS” or “the Department”) coordinated among the Safety Net Departments, with support from the Information Systems Department (ISD), an agreement with IBM to provide software and implementation of the Accessing Coordinated Care and Empowering Self Sufficiency (ACCESS) Sonoma Data Hub Project (ACCESS Sonoma), which integrates all of the County’s rapid response safety net services.
This Board Item request approval to accept revenue of $1.6 million from the Substance Abuse & Mental Health Services Administration (SAMHSA) to implement Phase 6 for further improvements to the ACCESS Sonoma system with the addition of a Transitional Age Youth cohort, 2-1-1 Data Extract, and further computerized automation in the treatment plans for the Mental Health Diversion cohort through an addendum of International Business Machines (IBM) Corporation’s contract. Funds must be expensed by September 30, 2023. The Item also request authority to adjust the FY 22-23 Adopted Budget for receipt of the funds and expense for the addendum.
DHS was notified of funding availability in the amount of $1.6 million in FY 2021-2022, for which U.S. Representative Mike Thompson advocated that the Federal HHS department grant to DHS the sum for its the ACCESS-Sonoma program supported by IBM’s Watson-Care artificial intelligence platform. While the ACCESS-Sonoma program received a “green-light” initially in FY 21-22, DHS was invited in June 2022 to submit its credentials and official programmatic objectives to SAMHSA. Finally, the proceeds of the $1.6 million were fully associated with ACCESS-Sonoma by September 30, 2022. There are no Federal or State matching funds required, but DHS and its partner departments in the county are spending labor hours “in-kind” to project-manage and develop the technical tools within the IBM system platform. Furthermore, DHS and its county partners must demonstrate to SAMHSA that the target client-populations of ACCESS-Sonoma within the county will benefit through periodic reporting requirements to HHS.
Addendum 6 augments the ACCESS-Sonoma project in three ways:
• Using SAMHSA funds, the current Mental Health Diversion Cohort (MHDC) program will undergo a conversion of largely manual procedures into cloud-based automation in the IBM and Merative Integrative Care Solution.
• Integration of the 2-1-1 community provider directory data into the ACCESS Sonoma hub.
• The SAMHSA funds will be used to develop a new cohort for Transitional Age Youth, aged 18-25, from adult foster youth and adult probation who need assistance with accessing services including supportive housing, behavioral health and substance abuse treatment programs, food security, and medical insurance.
This latest phase of the ACCESS-Sonoma initiative will continue to build upon the successful coordination of service delivery among county agencies already established in earlier phases of the initiative. Clientele from among the most vulnerable populations and identified high-utilizers of county services will continue to benefit from the IBM Care Platform, specifically misdemeanants participating in the Mental Health Diversion program and young adults from 18 to 25 who are on adult probation or in the adult foster care system.
Discussion:
ACCESS Sonoma To Date
The development of the ACCESS Sonoma system has been executed in multiple phases with each phase delivering added functionality to the system. The Safety Net Departments have completed Phases 1 through 5 of the multiphase initiative, as follows:
• Phase 1 Rapid Prototype delivered the core database (Data Hub) with an initial view of basic client information.
• Phase 2 added homeless services information to the database, as well as client care planning and goal tracking, and incorporated roles-based security for future expansion.
• Phase 3 configured criminal justice data and expanded system security roles, electronic authorization forms, and system infrastructure related to a subsequent implementation phase of the project.
• Phase 4 included setting up an environment in the data center for testing and ACCESS Sonoma development, piloting improvements to client consent management, and adding an alert function for important care team notices. In addition, a COVID-19 cohort with two new assessments was developed in response to the COVID-19 pandemic.
• Phase 5 included: 1) implementation of a mental health diversion cohort care plan; 2) addition of Sheriff data to the data hub; 3) implementation of a client portal for self-progress tracking; 4) expanded security by creating custom client lookup for Sheriff and Probation extracts; 5) implementation of a provider portal for clinics, hospitals, and homeless shelters; and 6) provision for development of the technology component necessary to facilitate relocation of the system data component to the cloud at a future time.
• In September 2020, the Board of Supervisors provided via the FY 20-21 budget hearings $220,000 of ongoing funding to support staffing of an ISD Project Manager, there was one-time funding of $185,000 for migration and hosting costs, and additionally there was $530,000 for FY 21-22 and FY 22-23 to support project costs.
• In September 2022, the grant was awarded to Sonoma County for $1.6 million from the Community Funded Project through a formal application that had been submitted to the SAMSHA Division of the U.S. Department of Health & Human Services in July 2022.
Addendum 6 for Mental Health Diversion Cohort (MHDC)
On March 20, 2018, the Board approved an agreement with IBM to provide software in support of the rapid deployment of an integrated data hub and frontend user application for the ACCESS Sonoma County initiative. IBM had designed and developed the software applications for all previous cohorts in the ACCESS-Sonoma program; and so it was logical and efficient to continue with IBM as a proven software developer. MHDC currently works with individuals with mental illness in the criminal justice system, who qualify for diversion. Individuals are screened for program requirements which include being vulnerable, high-end utilizers, and have a qualifying mental health condition. If qualified, individuals are provided services including case management, individual and group counseling, housing services, substance use screening, medication monitoring, and assistance accessing benefits. This is currently a small cohort (20+ individuals).
a) Expansion of Care Plan and services will be achieved through the configuration of existing functionality and the development of new features. Implement Mental Health Diversion assessment enhancements to assist in evaluation of candidates for MH Court Diversion and provide reporting on assessments.
b) Configure care plan to capture and track client metrics including both the completion of successful events, and avoidance of negative events. Track clients progressing through levels of care and services. To the extent possible, automation will be deployed to assist with the management of the care plan goals and activities.
Addendum 6 for 2-1-1 Data Extract
2-1-1 is a resource directory service provided by United Way of the Wine Country for Sonoma County. It is a comprehensive directory of community resources and organizations that provide services for Sonoma County residents.
a) Integration of the 2-1-1 community provider directory data into the ACCESS Sonoma hub. This will enable the IMDT and individuals using the ACCESS Sonoma app to search for services in a consolidated service directory.
Addendum 6 for Transitional Age Youth (TAY)
Addendum 6 creates a new cohort of Transitional Aged Youth (TAY), aged 18-25, from adult foster youth and adult probation who need assistance with accessing services including supportive housing, behavioral health and substance abuse treatment programs, food security, and medical insurance to help provide overall stability that leads to better outcomes.
a) The Care Coordination platform will be expanded to include a new program designed specifically for TAY. This program will allow for IMDT members to share progress on goals, complete intake forms, complete assessments and share notes regarding touchpoints with other participating members.
b) A responsive web app will be available for TAY clients to access information from their care team members including exchanging messages, receiving relevant alerts, and sharing aspects of their care plan. This secure app will be available on mobile devices.
c) With the expansion of the program, opportunities will exist for new community partners to utilize the IBM and Merative Integrative Care Platform. New security policies will be created to provide managed and appropriate access for participating community partners.
d) Dashboards will be configured to track key performance indicators requested by the IMDT specifically for this cohort.
Prior Board Actions:
On May 25, 2021, the Board approved Addendum 5 to the Statement of Work with IBM for the annual renewal of software subscriptions, and Project Change Request 1 for cloud migration and cloud hosting of the ACCESS Sonoma Data Hub Project, in an amount not-to-exceed $1,945,634 through June 30, 2024.
On September 8, 2020, the Board included funding in the FY 2020-2021 adopted budget for 1.0 Information Systems Department Project Manager $220,000, and migration and hosting costs of $185,000 for a total of $405,000. FY 21-22 and FY 22-23 included $530,000 each of one-time PG&E discretionary funds. Board documents specify “Establish appropriations for the ACCESS system for use of an Information Systems Department Program Manager and software costs. Annual cost of $220,000 for existing position is funded with ongoing; Software and cloud migration costs funded for three years; $185,000 in 2020-21 and $530,000 for the following two years.”
On September 1, 2020, the Board approved Addendum 4 to the Statement of Work with IBM for implementation of Phase 5 of the ACCESS Sonoma Data Hub Project, and any amendments that do not substantially change the scope of work or increase funding, in an amount not-to-exceed $1,500,000 through December 31, 2020.
On July 23, 2019, the Board approved Addendum 3 to the Statement of Work with IBM for implementation of Phase 4 of the ACCESS Sonoma Data Hub Project, increasing the contract amount by $1,500,000 resulting in a new total not-to-exceed amount of $6,297,000, and any amendments that do not substantially change the scope of work or increase funding.
On December 11, 2018, the Board approved Addendum 2 to the Statement of Work with IBM for implementation of Phase 3 of the ACCESS Sonoma Data Hub Project, increasing the contract amount by $1,800,000 resulting in a new total not-to-exceed amount of $4,797,000.
On August 8, 2018, the Board approved Addendum 1 to the Statement of Work with IBM for implementation of Phase 2 of the ACCESS Sonoma Data Hub Project, increasing the contract amount by $1,799,918 resulting in a new total not-to-exceed amount of $2,997,000.
On March 20, 2018, the Board approved a Statement of Work and Cloud Services Agreement with IBM to provide software in support of the rapid deployment of an integrated data hub and frontend user application for the ACCESS Sonoma County initiative, in an amount of $1,197,082.
On December 5, 2017, the Board: 1) received a report on the activities underway to address the Board priority to Secure the Safety Net and 2) adopted a resolution approving the county Safety Net Departments and Community Development Commission to strengthen coordinated, client-centered care delivery strategies and develop an information hub to facilitate successful implementation of disaster rapid response efforts, ACCESS Sonoma County, and Whole Person Care projects.
Fiscal Summary
|
Expenditures |
FY 22-23 Adopted |
FY 23-24 Projected |
FY 24-25 Projected |
|
Budgeted Expenses |
1,600,000 |
|
|
|
Additional Appropriation Requested |
|
|
|
|
Total Expenditures |
$1,600,000 |
0 |
0 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$1,600,000 |
|
|
|
Fees/Other |
|
|
|
|
Use of Fund Balance |
|
|
|
|
Contingencies |
|
|
|
|
Total Sources |
$1,600,000 |
0 |
0 |
Narrative Explanation of Fiscal Impacts:
The SAMHSA grant award of $1,600,000 from the U.S. Department of Health & Human Services will fully fund this current Phase (#6) of ACCESS-Sonoma without the need for County match. The IBM contract to execute the technology-based solutions for the aforementioned cohorts, will utilize the new revenue within FY 2022-2023. If the funds are not fully expended by the fiscal year’s end, funds can be rolled over into FY 2023-2024 budget, but not beyond the Federal Fiscal Year ending 09/30/2023.
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Staffing Impacts: |
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|
Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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|
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|
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Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Department of Health and Human Services Notice of Award
Attachment 2 - IBM Consulting Services Addendum 6 for ACCESS Sonoma
Attachment 3 - Budget Resolution
Related Items “On File” with the Clerk of the Board:
None