Committee holds large amendment to out‑of‑home care master contract for further vetting

The Cuyahoga County Health and Human Services and Aging Committee on Feb. 5 declined to advance a major amendment to the county’s out‑of‑home care master contract and instead kept the item in committee while staff supply additional information.

Clerk read Resolution 20250069, which would authorize Amendment 10 to the master contract for Medicaid home and community‑based out‑of‑home placement and foster care services. The measure, as read into the record, would extend the contract period to March 31, 2026, make the amendment effective Jan. 1, 2025, add new providers and authorize additional funds in an amount not to exceed $83,877,274.99.

David Merriman of the Department of Health and Human Services acknowledged the request represents a "significant increase" and said the county is negotiating with a number of providers. He thanked the council for a prior first‑reading suspension that allowed emergency payments on November and December invoices and said shifting the contract start to a March timeframe would help align with state procurement developments.

Marcos Cortez (Health and Human Services) said this is the tenth amendment to the master agreement that began Jan. 1, 2022. The master contract covers therapeutic foster care, specialized foster care, group homes, independent living and residential care. Cortez said the amendment would include roughly 75 vendors and is an option year extension; the county will need to run a new procurement this year if it seeks to extend beyond March 2026.

Jacqueline Fletcher, director of the Division of Children and Family Services, said the amendment is vital to ensure placement continuity and payment processing. She told members the division currently has "over 2,100" children in its care and that the amendment would reduce the likelihood of payment processing challenges at year‑end.

Committee members pressed staff on why the contract has required multiple amendments and on a specific provider that had an abuse allegation reported publicly. Councilman Sweeney said an incident seen on television heightened public concern; Merriman and staff said the employee left the organization, the state investigated, and the provider retains its state license. Staff emphasized ongoing monitoring, monthly visits to placements and quality‑assurance criteria for vendors.

Members also asked about vendor selection criteria, recruitment of foster families and permanency timeframes. Fletcher outlined licensing and quality‑assurance minimums, outreach to providers in other regions when capacity exists, recruitment efforts emphasizing kinship placements, trauma‑informed training, respite options and a general goal of pursuing permanency within a 12‑month timeframe while allowing extensions when service access or other barriers exist.

After the questions, the chair said the committee will retain the item in committee while staff provide answers and vendor signatures. Merriman reiterated that the contract would start Jan. 1 and run to March 2026 if enacted, and staff and members agreed to continue vetting the amendment.