County ends arrangement with Be Well to run Mental Health and Wellness campus

The Orange County Health Care Agency ended its arrangement with the nonprofit running the Mental Health and Wellness campus in Orange in late August after an audit found deficiencies in how billing and training were handled.

But representatives for the treatment provider say many of this issues were fixed and claim they were blindsided by the decision to pull their funding.

Mind OC conducts outreach to the homeless community and connects people with various mental health and substance abuse treatment programs throughout Orange County under the name Be Well OC. Since 2021, it has been running the Mental Health and Wellness Campus in partnership with the Orange County Health Care Agency.

The Orange County Board of Supervisors committed $16.6 million for the development of the Orange campus. Additional investments came from the County’s Medical Provider CalOptima and local hospitals whose officials anticipated that the facility would alleviate caseloads in their ERs.

An audit conducted in July cited 38 issues with how Mind OC conducted staff training, credentialing and quality management for two subcontractors providing services at the Orange campus, Exodus Recovery Inc. and HealthRight 360, according to documentation obtained by LAist via public records requests. It also raised concern over the potential for inaccuracies in billing.

“It had nothing to do with clinical care,” Mind OC chief executive Phillip Franks told the Daily Pilot Thursday. “It was the county monitoring our ability to do county level contract monitoring.”

However, training and monitoring was “precisely what Mind OC was contracted to do,” OC Health Care Agency spokeswoman Ellen Guevara told the Daily Pilot in a statement. County officials say it was ultimately the nonprofit’s responsibility to ensure that the providers they were working with were adhering to best practices and submitting proper documentation to authorities. Failure to do so placed “those programs and other programs in the County system of care at risk,” Guevarra said.

The majority of the complaints in the audit specifically targeted crisis support programs at the campus like the crisis stabilization unit and emergency hotline. Until recently, those had been subcontracted to Exodus.

Auditors found that calls would sometimes go unanswered while Exodus was running the hotline. Franks said the subcontractor also wasn’t doing a good job of referring people who called in to services, which meant the campus wasn’t helping as many people as it could have been.

Exodus announced plans to stop working with Mind OC in March, and so the latter prepared to fill in for the crisis support services the subcontractor had been handling, Franks said. He said they had invested heavily into this effort, including restaffing the hotline with registered nurses available 24/7. He added that since then, the call center has been fielding 80 to 90 calls each day, and practically all of the programs at the Mental Health and Wellness campus are full with patients.

Franks said access to care at the campus improved dramatically after Be Well made those changes. That’s why they were shocked when OCHCA told them it would be ending its arrangement with the nonprofit on Aug. 29.

“We had been planning to take on those services, hiring up our staff ...” Franks said. “It came as a complete and total surprise a couple Thursdays ago when we were given a termination notice.”

County officials point out that Mind OC was never contracted to set up a hotline and had been asked on several occasions to direct patients to an existing 24/7 support line, OC Links. Exodus contends any deficiency in responsiveness cited by the audit was “due to Mind OC’s lack of support and lack of subject matter expertise in understanding regulations in the public health behavioral space,” Guevara said.

Franks said about 100 Be Well staff would be laid off as a result of their departure from the Orange Campus. However, Guevara said the staff he referred to were Exodus contractors who will continue working at the campus under direct contract with the County instead of as a subcontractor for Mind OC.

“This decision is based on an ever-evolving public, private partnership model,” according to a joint statement from the OCHCA and Mind OC. “The HCA will manage the landscape of Medicaid programs at the site and partner with Exodus Recovery Inc. and HealthRight 360 to ensure continued high-quality psychiatric crisis and substance-use disorder services.”

Franks said he was concerned about Exodus stepping back into the picture, given his claim that many of the issues raised in the audit were related to subcontractors.

“The audit was not of Exodus,” Guevara said. “The audit was of Mind OC and their ability to provide oversight and support for providers.”

Meanwhile, OCHCA is still working with Be Well to open a second Mental Health and Wellness Campus at Great Park in Irvine. That deal has not been affected by developments at the Orange campus, Franks said.

The termination of Be Well’s involvement at the Orange campus came two days after the Newport Beach City Council decided to end the city’s $1.2-million contract with the nonprofit to run a street health program. Council members and residents offering public comments said they didn’t feel the program had achieved enough “street exits,” a term for moving homeless people out of tents and encampments.

Franks explained that the nonprofit was focused on earning people’s trust and gradually encouraging them to get the support they needed. Unlike police, Be Well’s caseworkers don’t have the authority to force people out of encampments and out of public sight.