title
CC - CONSENT ITEM: (1) Approve An Amendment to the Existing Professional Service Agreement with Healthcare in Action for Street-Based Medical Services for Unhoused Residents in an Amount Not-to-Exceed $400,000 for the Time of Performance from 02/01/2025 through 01/31/2026; OR 2) Approve an Amendment to the Existing Professional Service Agreement with Healthcare in Action for Street-Based Medical Services for Unhoused Residents in an Amount Not-to-Exceed $574,665 for the Time of Performance from 02/01/2025 through 01/31/2026 to Include the Integration of Behavioral Health Services.
body
Meeting Date: February 24, 2025
Contact Person/Dept: Tevis Barnes/Housing and Human Services
Phone Number: (310) 253-5780
Fiscal Impact: Yes [X] No [] General Fund: Yes [X] No []
Attachments: Yes [] No [X]
Public Notification: (E-Mail) Meetings and Agendas - City Council, Housing Issues (02/19/2025); and Health Care in Action (12/23/2024).
Department Approval: Tevis Barnes, Housing and Human Services Director (02/03/2025)
_____________________________________________________________________
RECOMMENDATION:
Staff recommends the City Council (1) approve an amendment to the existing professional services agreement with Healthcare in Action (HIA) for street-based medical services for unhoused residents in an amount not-to-exceed $400,000 for the time of performance from 02/01/2025 through 01/31/2026; OR (2) approve an amendment to the existing professional services agreement with HIA for street-based medical services for unhoused residents in an amount not-to-exceed $574,665 for the time of performance from 02/01/2025 through 01/31/2026 to include the integration of behavioral health services.
BACKGROUND/DISCUSSION
Health Care In Action
Healthcare in Action (HIA) Medical Group is a non-profit exclusively dedicated to providing medical care and social services for patients experiencing homelessness using a “street medicine” model. HIA currently has 11 mobile healthcare teams providing medical and case management services to six counties throughout California.
On November 13, 2023, the City Council approved an agreement with HIA in an amount not-to-exceed $400,000 to serve 125 unhoused patients through street-based medical services.
Scope of Services
Healthcare in Action offers full scope general medical services, addiction treatment, psychiatric care, and case management for the unhoused populations. HIA brings these services to unhoused patients using fully equipped mobile medical vans similar to what would be found in a doctor’s office. Through this street medicine approach, HIA can offer the same comprehensive medical and social services as a community clinic for the most vulnerable unhoused residents who do not access traditional medical facilities.
HIA provides direct patient services during standard weekday business hours. There is also an on-call clinician available by phone 24/7. If approved by Council, HIA will continue to provide weekly service throughout Culver City to various locations with high concentration of unhoused as well as weekly medical clinics one day a week at Project Homekey (PHK), Wellness Village (Safe Sleep), and to the two local motels under the Motel Master Leasing Program.
With the amendment to the existing agreement, HIA will continue to provide the following scope of services:
o Weekly medical clinics at PHK, Wellness Village, and the two local motels with long-term leasing agreements with the City under the Motel Master Leasing Program
o Weekly medical outreach and services during the Tuesday Care and Service Day
o Proactive medical outreach and service to locations throughout the City were unhoused persons congregate
o Full scope primary medical care
o Addiction counselling and medication-assisted treatment
o Psychiatric care, including medication management
o Laboratory testing
o Point-of-care ultrasonography
o Medication dispensary/delivery of medications from pharmacies
o Referrals and transportation to medical specialist appointments
o Enrollment in the Coordinated Entry System (CES)
o Other social services, including support with food stamps, disability and other social service program applications.
o Provision of mobile phones and GPS tracking devices to enhance communication between patients and the clinical team.
Staffing Levels
With the continuation of the HIA agreement, the staffing levels are as follows:
o 1 Full-Time Nurse Practitioner
o 1 Full-Time Medical Assistant
o 1 Full-Time Behavioral Health Specialist
o 2 Full Time Peer Navigators
o 1 Full-Time Physician Supervisor
Year in Review - Status Update
Some of the impactful outcomes achieved by HIA over the last 12 months include the following:
o 152 patients served
o 91% of patients received case management services
o 77% of patients received medical care
o 38% of patients received mental health treatment
o 29% of patients received substance use treatment
o Enrolled 109 unhoused patients in Medical and/or Enhanced Care Management Services
o 68% of patients engaged in five or more medical visits
Behavioral Health Services
As an alternative option, HIA requests an amendment to the existing agreement in the amount of $574,665 (this is an increase of $174,665 from the Fiscal Year 2024-2025 agreement) to continue current medical and case management services and add the integration of behavioral health services for unhoused residents of Culver City. With the additional requested funds, HIA aims to enhance capacity to help ensure timely, coordinated, and consistent care.
By integrating a behavioral health professional, HIA will be able to provide immediate assessments, crisis interventions, and continuity of care without the logistical challenges of navigating external systems such as the Los Angeles County Department of Mental Health where there might be extended waiting periods for an appointment. This expansion will include hiring a licensed behavioral health professional and offering culturally competent training for HIA staff members.
Moreover, having an internal behavioral health component would allow HIA to provide a more holistic, team-based approach, where medical, behavioral, and social services are seamlessly coordinated. This integration fosters trust and rapport, as patients will be able to receive consecutive, long-term therapy care from familiar providers in a trauma-informed environment. Additionally, building internal capacity ensures greater flexibility to community needs, creates sustainability by reducing dependence on external systems, and positions patients to engage in innovative, tailored interventions to improve overall health and well-being.
The Behavioral Health Specialist would interact with and provide services to Culver City clients through the following scope of services:
o Provide individual and group counseling to clients, focusing on behavioral health challenges and psychosocial needs.
o Support clients in developing coping strategies to address trauma, serious mental illness (SMI), substance use, and barriers to housing and vocational stability.
o Collaborate with clients to create individualized care plans and coordinate services that promote resilience and long-term stability.
o Serve as a liaison with community partners to connect clients to mental health, social services, and housing resources.
o Coach HIA staff members to create and implement strategies that minimize risks associated with the identified common health conditions and behaviors.
o Connect HIA staff members to appropriate programs to address barriers to care and to enhance compliance.
FISCAL ANALYSIS
On November 13, 2023, the City exercised its authority under the Homeless Emergency declared on January 3, 2023, to waive formal procurement procedures to secure the services of HIA to implement mobile homeless healthcare and enter into a one-year agreement. On January 9, 2023, City Council adopted a resolution ratifying the Proclamation of Local Emergency on Homelessness by the Director of Emergency Services of the City of Culver City, California, issued by the City Manager on January 3, 2023. Culver City Municipal Code (CCMC) Sections 3.07.060.B and 3.09.040 enable the City to purchase equipment, goods, supplies and services made in connection with emergency activities in the event of a locally declared emergency without following the bidding procedures otherwise required by the CCMC.
Staff recommends amending the agreement with HIA for an additional year. If City Council agrees, Council may consider either approving an amendment to the existing agreement with HIA in the amount of $400,000 for the continuation of current services or approve an amendment in the amount of $574,665 which reflects an increase of $174,665 for the inclusion of a behavioral health services component which includes the hiring of a Behavioral Health Specialist and offering culturally competent training for HIA staff members.
The Adopted Budget for Fiscal Year 2024-2025 includes sufficient funds for the first five months of the agreement (either $166,667 or $239,444) in Account No. 10135100.619830 (Housing Administration - Other Contractual Services Unhoused) in the Housing and Human Services section of the budget book on page 299. Funding for the remaining seven months of the agreement would be included in the budget for Fiscal Year 2025-2026.
ATTACHMENTS
None.
MOTION
That the City Council:
1. Approve an amendment to the existing professional service agreement with Healthcare In Action for street-based medical services for unhoused residents in an amount not-to-exceed $400,000 for the time of performance from 02/01/2025 through 01/31/2026;
OR
2. Approve an amendment to the existing professional services agreement with Healthcare in Action for street-based medical services for unhoused residents in an amount not-to-exceed $594,738 for the time of performance from 02/01/2025 through 01/31/2026 to include the integration of behavioral health services.
AND
3. Authorize the City Attorney to review/prepare the necessary documents; and,
4. Authorize the City Manager to execute such documents on behalf of the City.