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Agenda 12/08/2020 Item #16D16 (Waiving requireements for full quartly pymt to DLC FY20)12/08/2020 EXECUTIVE SUMMARY Recommendation to waive the requirement that services be unduplicated and allow the full final quarterly payment to the David Lawrence Center for FY20 due to unforeseen COVID impacts resulting in a decrease in unduplicated client served and reduced prevention units provided. OBJECTIVE: To promote availability and access to mental health and substance abuse services for residents of Collier County. CONSIDERATIONS: Annually the County enters into an agreement with the David Lawrence Center (DLC) to meet the requirements of Section 394.76(9) (a) and (b), Florida Statutes, requiring a local match to state-funded community alcohol and mental health services. The County entered into the annual agreement for FY20 on November 12, 2019, Agenda Item #16D2. As part of this agreement, the County requires DLC to meet two (2) annual performance targets; unduplicated clients served and prevention units. Pursuant to Article III, the County reserves the right to withhold and/or reduce an appropriate amount of any payment for work not performed satisfactorily to the contractual requirements. The FY20 agreement provides quarterly payments and the fourth quarter payment is contingent upon achievement of the annual targets. DLC’s ability to meet this year’s annual performance targets was impacted by the onset of the COVID-19 pandemic in early March. This is an unforeseen circumstance outside the control of DLC. Prior to the onset of COVID, DLC was on target to meet each of their performance targets. COVID-19 affected DLC operations for the second six (6) months of this contract’s fiscal year. The suspension of in -person services and subsequent conversion to telehealth services in DLC’s centralized Access Center and outpatient/community-based programs led to a decrease in the total number of unique unduplicated individuals served for this fiscal year. While DLC did make a remarkably rapid, comprehensive, system - wide transition to video/telephonic/mobile provision of services, many new potential clients remained hesitant to initiate or link with outpatient appointments. The resulting decrease in outpatient service volume experienced at DLC is consistent with trends reported by comparable community behavioral health agencies throughout the state, as reported in regular meetings of statewide coalitions and associations. Overall service volume at DLC for the fiscal year did increase, as evidenced by 1) added service lines throughout the year, and 2) many individuals already engaged in services required additional services due to increased acuity of symptoms. The total number of defined services provided to Collier County residents increased five percent (5%) however the number of unduplicated clients did not increase as expected. DLC did achieve eighty-six percent (86%) of the projected target of 7,900 unduplicated clients served. In addition, the closing of the Collier County Public Schools (CCPS) in March for in-person delivery of prevention services greatly impeded DLC’s Prevention Team’s ability to provide the projected service volume, as a significant portion of Prevention services are provided through face-to-face services with CCPS students. However, the DLC Prevention Team successfully converted several of their programs into online formats, thus minimizing the total impact of the pandemic on the total number of Prevention Services for the year, reaching ninety-eight percent (98%) of the target or 6,468 units of the required 6,600 prevention units. It should be noted that while the total number of unique individuals served and volume of prevention services provided between October 1, 2019 and September 30, 2020 were lower than the annual target, DLC provided close to 12,000 additional services overall to Collier County residents during this time period compared to the prior year (an increase of five percent (5%)). In addition, DLC experienced a significant increase in the demand for crisis stabilization services during the same time frame. The total 16.D.16 Packet Pg. 3124 12/08/2020 number of bed days provided in the Crisis Stabilization Unit (CSU) increased by 1,462, representing a sixteen percent (16%) increase for the year to a total volume of 10,545 days. CSU bed days in the second half of the year alone (April through September 2020) increased by twenty -three percent (23%) (or 998 days) compared to the same time period in 2019. DLC has historically overproduced in-service units each year and the circumstances this year prohibiting them from achieving this goal were unforeseen and not within their control. FISCAL IMPACT: Funding for the final FY 20 David Lawrence Center contract quarterly payment in the amount of $583,983.50 is available for payment from the FY 20 Community Mental Health budget 001 -156010. LEGAL CONSIDERATIONS: The Agreement with DLC expired on September 30, 2020. This approach is the most viable for DLC to receive payment. This item is approved for form and legality and requires a majority vote for Board action. -JAB GROWTH MANAGEMENT IMPACT: There is no Growth Management impact. RECOMMENDATION: To waive the requirement that services be unduplicated and allow full final quarterly payment to the David Lawrence Center for FY20 due to unforeseen COVID impacts resulting in a decrease in unduplicated client served and reduced prevention units provided. Prepared By: Kristi Sonntag, Director, Community and Human Services Division ATTACHMENT(S) 1. Fully executed DLC State Mandated Contract 2019 2020 (PDF) 16.D.16 Packet Pg. 3125 12/08/2020 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.16 Doc ID: 14228 Item Summary: Recommendation to waive the requirement that services be unduplicated and allow the full final quarterly payment to the David Lawrence Center for FY20 due to unforeseen COVID impacts resulting in a decrease in unduplicated client served and reduced prevention units provided. Meeting Date: 12/08/2020 Prepared by: Title: Manager - Federal/State Grants Operation – Community & Human Services Name: Kristi Sonntag 11/12/2020 11:56 AM Submitted by: Title: Manager - Federal/State Grants Operation – Community & Human Services Name: Kristi Sonntag 11/12/2020 11:56 AM Approved By: Review: Community & Human Services Kristi Sonntag CHS Review Completed 11/12/2020 12:04 PM Community & Human Services Maggie Lopez Additional Reviewer Completed 11/17/2020 6:17 PM Operations & Veteran Services Kimberley Grant Level 1 Reviewer Completed 11/18/2020 1:35 PM Public Services Department Todd Henry Level 1 Division Reviewer Completed 11/18/2020 1:58 PM Operations & Veteran Services Todd Henry Additional Reviewer Skipped 11/12/2020 11:59 AM Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 11/19/2020 8:16 AM Grants Erica Robinson Level 2 Grants Review Completed 11/19/2020 10:06 AM County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 11/19/2020 1:32 PM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 11/19/2020 1:47 PM Grants Therese Stanley Additional Reviewer Completed 11/20/2020 1:32 PM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 11/20/2020 2:23 PM Budget and Management Office Ed Finn Additional Reviewer Completed 11/30/2020 12:03 PM County Manager's Office Sean Callahan Level 4 County Manager Review Completed 12/02/2020 9:54 AM Board of County Commissioners MaryJo Brock Meeting Pending 12/08/2020 9:00 AM 16.D.16 Packet Pg. 3126 16.D.16.a Packet Pg. 3127 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3128 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3129 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3130 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3131 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3132 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3133 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3134 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3135 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3136 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3137 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3138 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3139 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20) 16.D.16.a Packet Pg. 3140 Attachment: Fully executed DLC State Mandated Contract 2019 2020 (14228 : David Lawrence Center FY 20)