Orange County supervisors continue decision on suicide services contract after hours of testimony

The Orange County Board of Supervisors on May 20 postponed a decision on a health care agency recommendation to award a contract for countywide suicide and self-harm reduction services, after dozens of emotional public comments and a lengthy board discussion about procurement rules and program continuity.

The item (agenda item 36) proposed awarding the contract to Orange County Asian and Pacific Islander Community Alliance (OCAPICA) for a service model that includes Medi‑Cal billing, while Didi Hirsch Mental Health Services would retain the county’s 988 hotline function. County staff told supervisors that OCAPICA scored higher in the procurement interview portion — particularly on questions about Medi‑Cal certification and billing — and that the scoring, not the organizations’ reputations, drove the recommendation. Ian Kemmer, behavioral health director for the county Health Care Agency, said: "This is not a service that's going away. And Didi Hirsch does actually keep the 988 line. This is just the postvention services that we're talking about that went out to RFP."

Why the board paused: More than 40 speakers signed up specifically for this item, and many survivors, clinicians and family members urged the board not to disrupt services currently provided by Didi Hirsch, which they described as specialized and irreplaceable. Lynn Morris, CEO of Didi Hirsch, told the board that her agency has decades of specialized suicide-prevention and postvention programs and asked supervisors to "reconsider this agenda item and award the contract to Didi Hirsch." Several supervisors said the choice boiled down to fiscal sustainability versus continuity of specialized care.

County staff outlined the fiscal trade-offs the board faces. The proposed contract is funded with Mental Health Services Act (MHSA) prevention dollars totaling $1.65 million; under the Behavioral Health Services Act (BHSA) framework the county expects to require Medi‑Cal billing for a portion of these services. Staff estimated the county could draw about $1.8 million in Medi‑Cal reimbursements if a certified provider bills at projected productivity levels, a figure supervisors raised repeatedly during questioning. Procurement staff said personnel and site certification take time; the county's internal certification and site-review process would take weeks to months after a contract is in place, then the county submits to the state for final approval. Procurement explained OCAPICA’s interview responses on Medi‑Cal billing were scored higher than Didi Hirsch's during the panel review, which is why the recommendation favored OCAPICA.

Board action and next steps: Supervisors asked staff to return with concrete options — including the costs and service impacts of splitting the contract between two providers, the projected net Medi‑Cal revenue, and an analysis of which services would have to be trimmed if billing assumptions are not met. By unanimous consent the board continued the item to its June 24, 2025 meeting and directed staff to provide the requested analyses and transition scenarios and to allow public comment when the item returns.

What this means for clients: Staff said they expect no immediate service disruption; the county intends to extend incumbent services for a limited transition period (staff said up to three months) to avoid gaps for people already in care. Supervisors emphasized the board’s priority to preserve continuity for clients while also ensuring the county can maximize reimbursement under the new state requirements.

The board’s decision to continue the item does not finalize a contract. The June 24 meeting is expected to include a staff return on cost scenarios, certification timetables and options for ensuring continuity for currently served clients.