March 12, 2020 — The Board of Supervisors agreed unanimously this week on a three-part motion regarding money, data, and mental healthcare services.
While no timeline was specified, Redwood Quality Management Company (RQMC), the current mental healthcare contractor, and all its subcontractors, were asked to turn over their patient outcome data to the county Health and Human Services department, with a referral to the Behavioral Health Advisory Board (BHAB) for analysis.
BHAB is also expected to consult with county staff and come up with a process to put adult mental healthcare services out to bid, which has not been done since RQMC took over adult mental healthcare from the previous contractor, Ortner Management Group, in 2016.
And County CEO Carmel Angelo received direction to return with an estimate of mental health funds that are available to repurpose to meet Measure B promises.
Initially, the proposals did not appear popular.
Supervisor Carre Brown took umbrage with the item, and with Supervisor Ted Williams, who brought it forward, saying that she did not believe he had done historical research into mental healthcare in the county. When the state hospitals closed, she said, local governments were left to put together a mental healthcare system using federal money and local providers. She said RQMC made significant improvements on Ortner’s record-keeping, and suggested Williams attend BHAB meetings and consult with staff to get answers to his questions.
Leaders of the SEIU Local 1021, the largest county workers’ union, supported the resolution and suggested more services be brought ‘in-house,’ while subcontractors in the non-profit social services field strove, with three minutes each, to provide a snapshot of the work they do with RQMC.
County Behavioral Health Director Dr. Jenine Miller told the board the mental healthcare system has four separate audits, which determine if the system meets federal requirements, whether or not every minute is billable, the medical necessity of each treatment, and, ultimately, if contractors will have to reimburse the state or pay fees and fines for being out of compliance. She told the board that county mental health is 98% in compliance with state requirements.
The original agenda item contained no reference to the Behavioral Health Advisory Board, which has long advocated for improved mental healthcare services in the county. Meca Ferretta sits on that board, which she says is already working to review information about RQMC, including contracts and a “data dashboard,” which, she reported, contains three years of useful data. She told supervisors she felt that “the purpose and the process of the advisory board seems to be circumvented with this item.”
Williams made a final pitch for aggregating more data locally, and putting the services out to bid, by presenting the new approach as one that could bring in more money from state and federal sources, which rely heavily on data when allocating funds. “Likely what we’re going to find is more state and federal money would help us,” he said. “We’re making good use of what we have. That alone is worth the adventure of parsing the data.”