SR 08-08-2017 3J
City Council Report
City Council Meeting: August 8, 2017
Agenda Item: 3.J
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To: Mayor and City Council
From: Karen Ginsberg, Director, Community & Cultural Services
Subject: Modification of Homeless Multidisciplinary Street Team Contract
Recommended Action
Staff recommends that the City Council:
1. Authorize the City Manager to accept a grant award in the amount of $300,000
from Los Angeles County Board of Supervisors District 3 for the operation of the
Homeless Multidisciplinary Street Team (HMST), and to accept all grant
renewals.
2. Authorize the City Manager to execute all necessary documents to accept the
grant and all grant renewals.
3. Authorize the budget changes as outlined in the Financial Impacts & Budget
Actions section of this report.
4. Authorize the City Manager to execute a second modification to agreement
#10291 (CCS) in the amount of $1.05 million with Ocean Park Community Center
(OPCC), a California-based company, for the operation of the Homeless
Multidisciplinary Street Team. This will result in a 3 year amended agreement
with a new total amount not to exceed $1.65 million, with future year funding
contingent upon Council budget approval.
5. Authorize the City Manager to negotiate and execute a Software Licensing and
Professional Services Agreement with Akido Labs, a California based company,
for the development of data governance polices, user licenses, creation and
maintenance of data sharing platform for first responders. The recommended
award is made as an exception to the competitive bidding process pursuant to
Section 2.24.080 (d) and is for a term of four years with one three-year option to
renew for a total amount not to exceed $85,000 with future year funding
contingent on Council budget approval.
6. Authorize the City Manager to enter into a Memorandum of Understanding with
the University of Southern California (USC) and the Milken Institute to pursue
solutions to homelessness.
7. Authorize the City Manager to negotiate and execute a Professional Services
Agreement with RAND Corporation, a California-based company, for an
assessment of the HMST at no cost.
Executive Summary
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The Homeless Multidisciplinary Street Team (HMST) began operating in September
2016 as a jumpstart project in association with the Taking a Leadership Role in
Regional Homelessness Council-adopted strategic goal. HMST is staffed by a highly
skilled team of mental health, medical, and substance abuse professionals, and a peer
specialist. The team provides medical and behavioral health interventions on the
streets, in parks, jails and hospitals to the highest utilizers of City emergency services
(police, fire, hospitals). The RAND Corporation has offered to review HMST and City
data to assess the efficacy of providing intensive, clinical services in the field and the
cost effectiveness of this intervention. In addition, the City has been approached by the
University of Southern California’s (USC) partners, Akido Labs and the Milken Institute,
to develop a custom data sharing platform that would allow first responders to have
access to information about homeless individuals who are high users of emergency
services in order to facilitate safe and effective interventions in the field.
HMST received City jump start funds of $600,000 that will be expended through August
2017. An additional $150,000 has been identified in the FY 2017-18 budget to extend
the team through December 2017, with an additional $300,000 budgeted for FY 2018-
19. Los Angeles County Supervisor Sheila Kuehl has committed $300,000 in FY 2017-
18 discretionary funds and will consider another grant of the same amount for FY2018-
19. Staff recommends accepting the Supervisor’s discretionary funds and modifying the
City’s agreement with OPCC for a total amount not to exceed $1.65 million through
June 30, 2019 to deliver street-based medical and behavioral health care which would
enable the program to continue uninterrupted funded by County, City and possibly other
dollars. In addition, staff recommends entering into an agreement with Akido Labs to
create a data sharing platform for first responders as well as a Memorandum of
Understanding with the Milken Institute and USC’s Keck School of Medicine to
memorialize the new partnership, and an agreement with RAND Corporation to
complete an assessment of the HMST model.
Background
On August 23, 2015 (Attachment A), the City Council convened a special Council
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meeting and identified the City’s five top priority Strategic Goals including taking a
leadership role in regional efforts to address homelessness.
On October 27, 2015 (Attachment B), staff recommended appropriating $5.1 million of
one-time General Fund savings for projects that will produce measurable results in
support of Council’s Strategic Goals. Council approved a one-time allocation of
$600,000 to implement a Homeless Multidisciplinary Street Team (HMST). This team
builds upon the successful assertive case management model utilized by the Chronic
Homeless Project (CHP) and the comprehensive medical and behavioral health
approach used by the Integrated Mobile Health Team (IMHT) to address the changing
characteristics of the homeless community in the City.
On February 12, 2016, the City issued a Request for Proposals (RFP) for a Homeless
Multidisciplinary Street Team. The RFP was posted on the City’s online bidding system
in accordance with the City Charter and Municipal Code provisions. One proposal, from
the non-profit agency OPCC, was received and reviewed by staff from the Human
Services Division (HSD), the Police Department, the Fire Department, and the Library.
Reviewers found that OPCC has extensive experience providing integrated field-based
homeless services through their IMHT program, Multidisciplinary Integrated Team
(MIT), and the Department of Health Services C3 initiative in Skid Row and
recommended that they be selected for these reasons.
On April 26, 2016 (Attachment C), City Council authorized the City Manager to
negotiate and execute an agreement with OPCC to develop and operate HMST in an
amount not to exceed $600,000 for a one-year period. Contract # 10291 (CCS) was
executed on June 14, 2016 and fully staffed and operational in September 2016. The
initial contract amount will fund the program through August 2017. On June 7, 2017,
the First Modification to Grant Agreement 10291 (CCS) was executed between the City
of Santa Monica and OPCC to extend the HMST contract through December 31, 2017.
An additional $150,000 in strategic initiative contingency funding has been identified in
the FY 2017-18 budget to sustain the program through the end of the modified contract
term.
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In June 2017, Los Angeles County Supervisor Sheila Kuehl agreed to provide $300,000
in discretionary funds to sustain the program through June 2018. During budget
adoption on June 27, 2017, Council allocated an additional $300,000 of FY 2018-19
City of Santa Monica funds to operate HMST through December 2018 (Attachment D).
Supervisor Kuehl’s office will consider an additional $300,000 grant for FY 2018-19
operations to sustain the program through June 2019. This extension would result in a
strong, multi-year data set upon which to evaluate the effectiveness of this intervention.
The recommended second modification to the City’s agreement with OPCC would
increase the total dollar amount to $1.65million of City and County funds and extend the
term until June 2019. OPCC is in compliance with the Oaks Initiative (Attachment E).
Discussion
Prior to the launch of the HMST, the 25 homeless individuals on the initial cohort had
been treated by SMFD paramedics more than 200 times, transported to local hospitals
more than 100 times, and issued nearly 700 citations by SMPD. The 18 individuals
engaged by the HMST thus far represent a cumulative 195 years of street
homelessness. To date, seventeen clients have been taken off the streets since
engaging with the HMST, resulting in significantly decreased utilization of costly
emergency services by this group.
One HMST client had been chronically homeless in Santa Monica with numerous
arrests and hospitalizations related to public intoxication. He had rejected traditional
homeless outreach and mainstream services, due to the complexity of his physical and
mental health and substance use disorder. HMST worked with City staff and the County
Public Defender’s Office to arrange an alternative sentencing option. The client
completed a residential alcohol treatment program, was linked to a sober living program
at CLARE Foundation, employment training at Chrysalis, and a permanent housing
voucher through the regional Coordinated Entry System. This individual is now working
a full-time job in Santa Monica, and is regularly engaged in activities to promote his
sobriety, mental and physical health, and permanent housing. In the year prior to
engaging with HMST, this individual was arrested by SMPD four times and transported
by SMFD to local hospitals twice. Since participating in treatment with HMST, he has
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neither been arrested nor hospitalized. OPCC is tracking service and housing
outcomes using the City’s Homeless Management Information System (HMIS), as well
as engaging a third party evaluator to measure impact of services on clients’ wellbeing.
The cohort will evolve over time. City staff have identified additional vulnerable
individuals to be added to the HMST roster to replace those who have either died or the
HMST have been unable to locate. The contract extension would allow for an
assessment of “step down” interventions post-housing to determine how best to
transition participants from HMST to other lower-intensity support services, thereby
allowing the team to serve new individuals.
A forthcoming evaluation will examine cost avoidance and the effectiveness of this level
of intervention. Consistent multi-year assessments are necessary to demonstrate the
effects of social service interventions, the impacts of which are best measured by
changes over time as illustrated by other evaluative tools such as The Wellbeing Index
and the Youth Wellbeing Report Card. RAND Corporation has approach the City with
an offer to review the data collected by HMST, first responders and local hospitals,
looking specifically at the effectiveness of the intervention for this highly vulnerable
population and to see if the service model results in fewer contacts with local
emergency services. RAND is offering this at no cost to the City. Staff recommends that
the City enter into a professional services agreement with RAND for this work.
Should the evaluation of HMST confirm that this level of intervention is effective not only
in placing vulnerable clients in housing but also reducing the impact on local emergency
resources, the Community and Cultural Services Department may request an
enhancement of the Human Services Grants Program (HSGP) budget to provide
ongoing, sustainable funding for this program. The enhancement would be requested
for the next four-year (FY 2019-23) HSGP funding cycle. Discussions are also
underway to engage the business community to support this project as another ongoing
source of partial funding.
Vender Selection:
On October 25, 2016, as part of the City’s efforts to engage in regional solutions to
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homelessness, staff participated in a summit hosted by the Milken Institute. During the
summit, discussions of technology solutions prompted a suggestion from City staff that
providing first responders relevant information about homeless individuals in the field
could improve their interactions and lead to safer, more productive outcomes than
traditional enforcement alone. Representatives from the University of Southern
California (USC)’s Keck School of Medicine and the Milken Institute approached the
City in March 2017 offering to develop a custom data sharing platform for first
responders based on a similar health care data sharing system developed by Akido
Labs, a software company built out of Keck Medicine. Around the same time, staff
evaluated a similar product, GetRideALong.org, which was developed by a Code for
America team for the Seattle Police Department’s Crisis Response Team and gives
officers key information about people with mental illness at the scene. RideaLong
submitted a proposal for development of a custom software solution. Staff determined
that RideALong’s solution would have cost significantly more money and taken a much
longer time to develop than the solution proposed by Akido.
Akido has proposed a three-phased approach to supporting data sharing and the
coordination of care for homeless individuals who are frequently contacted by first
responders. The first and second phases, which include discovery, development of data
governance policies, and development, implementation, testing, and licensure of a pilot
solution, would not result in a cost to the City. This work is expected to take
approximately six months. The third phase of scaling, configuring, and implementing the
software for multiple year use would take approximately four months. A one-time user-
training fee of $5,000 would be charged at the end of FY17-18. Annual licensing and
support would likely begin in early FY18-19 and would be charged based in part on
needed support services. Service levels may vary over time as the solution is
implemented. A service level agreement exhibit would be included in the contract.
Additional services such as data analysis, design, development, and integration would
be priced at $150/hour. Staff recommends entering into a four-year agreement with
Akido not to exceed $85,000, with an option to extend the agreement by three
additional years, as an exception to the competitive bidding process pursuant to Section
2.24.080 (d) given the proprietary nature of the product and its specify to Santa Monica.
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Staff have tested the theory that that real-time data sharing significantly improves the
coordination of care for homeless individuals and have found it to be true; it is likely that
this type of software will have long-standing applicability, therefore a term of up to seven
years is proposed.
Additionally, staff recommends entering into a Memorandum of Understanding with the
Milken Institute and USC’s Keck School of Medicine (KSOM) to memorialize the
partnership, roles, and responsibilities. The Milken Institute will provide coordination,
convening, and research support on a local, regional and state level in partnership with
the members of the homelessness collaborative. USC KSOM’s primary role will be to
document, research, write and develop case studies for the projects. The City of Santa
Monica’s primary role will be to support research, development, deployment and
evaluation of technology based projects.
Financial Impacts & Budget Actions
The agreement modification to be awarded to OPCC is $1,050,000, for an amended
agreement total not to exceed $1,650,000. Funds of $450,000 are available in the FY
2017-18 budget in Strategic Initiative account SO015401.589000. Future year funding is
contingent on Council budget approval.
The agreement to be awarded to Akido Labs is for an amount not to exceed $85,000.
Funds of $85,000 are available in the FY 2017-18 budget in Strategic Initiative account
SO015401.589000 and 20262.522992. Future year funding is contingent on Council
budget approval.
Transfer of $150,000 in strategic initiative contingency funding, acceptance of a
$300,000 grant from Los Angeles County Board of Supervisors District 3 for the
operation of the HMST, and transfer of $85,000 in strategic initiative contingency
funding for the Akido Lab project require the following FY 2017-18 budget changes:
1. Transfer $150,000 from SO015601.589000 to SO015401.589000 to account for
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program expenditures through December 2017.
2. Establish revenue budget at account 20262.408500 in the amount of $300,000 to
facilitate receipt of the Supervisor’s grant.
3. Appropriate $300,000 to 20262.522992 to account for program expenditures
associated with the Supervisor’s grant.
4. Transfer $85,000 from SO015601.589000 to SO015401.589000 for costs associated
with the Akido Lab project.
For FY 2018-19, $300,000 is budgeted and available in account SO015401.589000. If
the Supervisor’s grant is renewed and awarded for future periods, budget changes will
be included in subsequent year budgets, contingent on Council budget approval.
Prepared By: Brian Hardgrave, Administrative Analyst
Approved
Forwarded to Council
Attachments:
A. August 23, 2015 Council Minutes (Web Link)
B. October 27, 2015 Staff Report (Web Link)
C. April 26, 2016 Staff Report (Web Link)
D. June 27, 2017 Staff Report (Web Link)
E. OPCC Oaks Initiative Form 2017
REFERENCE:
AGREEMENT NOS. 10522,
10523 & 10524 & Modification
to Agreement No. 10291
(CCS)