BHST Part One: Performance and Value-Based Contracting

This section presents excerpts selected by the evaluation team taken from the full report written by Mind OC. The full Mind OC report is available in Appendix A. Where the evaluation team added and/or revised text, an 'E' appears. Throughout this section, icons were also added, and text shortened to facilitate readability.

This component of the Behavioral Health System Transformation (BHST) Innovation involves the development of Performance / Value-Based Contracts. The project runs from October 2019 through June 2023. The Health Care Agency (HCA) has contracted with Mind OC to work collaboratively and with community stakeholders (e.g., consumers, family members, providers, etc.) to plan for strategies for value-based contracting and associated funding sources. The goal of shifting toward value-based contracting is to improve quality of and access to culturally responsive and inclusive behavioral health (mental health and substance abuse) services for all Orange County residents, regardless of insurance type. With Mind OC, Orange County is working with consumers, peers, family members and other community members, along with State and local agencies, public and private health plans, and philanthropic and non-profit organizations to create a coordinated system of care that bridges the public and private sectors to improve quality of and access to services.

While the timeline submitted to the Mental Health Services Oversight and Accountability Commission envisioned a project start in July 2019 (the third quarter of the 2019 calendar year), the actual start date was not until October 15, 2019. The following timeline is reflective of the current reporting period (Oct 2021-Sept 2022) and expected milestones.

• Explore strategies to braid funds across the public, private, and philanthropic/non-profit sectors • Operationalize identified values and performance standards into measurable outcomes • Develop methods to incentivize service delivery • Streamline reporting processes • Meetings with DHCS legal, fiscal, and regulatory teams • Develop and execute initial procurement and contracts • Provide technical assistance for local providers, as needed

• Explore strategies to braid funds across the public, private, and philanthropic/non-profit sectors • Operationalize identified values and performance standards into measurable outcomes • Develop methods to incentivize service delivery • Streamline reporting processes • Meetings with DHCS legal, fiscal, and regulatory teams • Develop and execute initial procurement and contracts • Provide technical assistance for local providers, as needed

• Operationalize identified values and performance standards into measurable outcomes • Meetings with DHCS legal, fiscal, and regulatory teams • Develop and execute initial procurement and contracts • Provide technical assistance for local providers, as needed

• Host local planning to help identify community values and preferred performance standards • Operationalize identified values and performance standards into measurable outcomes • Develop methods to incentivize service delivery • Streamline reporting processes • Meetings with DHCS legal, fiscal, and regulatory teams • Develop and execute initial procurement and contracts • Provide technical assistance for local providers, as needed • Progress updates to MHSOAC

The efforts of Mind OC to align legal, fiscal and regulatory requirements to improve quality and access to behavioral health services in Orange County are guided by nine project activities. The structure of Mind OC’s report will follow the below Project Activities:E 1. Explore strategies of braiding public, private and philanthropic/non-profit funds to create a universal reimbursement rate/structure

2. Host local planning to help identify community values and preferred performance standards

3. Operationalize identified community values and preferred, measurable performance standards

4. Develop methods to incentivize service delivery

5. Streamline reporting processes to comply with multiple sets of regulations and new performance outcome standards

6. Conduct meetings with DHCS, legal, fiscal, and regulatory teams

7. Develop methods and execute initial procurement and contracts incentivizing community defined and performance-based and regulatory standards

8. Prepare local providers for new performance standards and contracting through technical assistance

9. Provide progress updates to Mental Health Services Oversight and Accountability Commission (MHSOAC)