Orange County backs new intensive outpatient mental‑health services for youth; adult award deferred amid telehealth debate

Orange County supervisors on Tuesday approved a contract to expand intensive outpatient mental‑health services for children covered by Medi‑Cal but deferred a final decision on the adult award after extended public testimony and questions about telehealth, scheduling and accessibility.

The vote approved Children's Hospital of Orange County (CHOC) to provide the county’s new IOP/day‑treatment services for children while the board continued consideration of the adult providers to gather more data on hours, facility capacity and telehealth options. Vice Chair Katrina Foley and Supervisors Winn and Wagner voted to approve the CHOC contract; Chair Doug Chaffee and Supervisor Sarmiento voted no. Supervisor Katrina Wynne moved to split the awards so the children's contract could proceed while the adult award was continued for more information.

Board members said the county needs evidence‑based services that Medi‑Cal beneficiaries can actually access. Healthcare Agency Director Dr. Veronica Kelly and Ian Kemmer, director of behavioral health services, described the county’s priorities: rapid access after hospital discharge, language access and the ability to bill Medi‑Cal under new state billing rules. Kemmer said the county’s aim is to “provide the service immediately upon discharge” while adhering to the program timelines in the request for proposals.

Multiple provider representatives—Jenna Jensen and colleagues who helped craft the proposals—urged the board to approve contracts that will expand access for Medi‑Cal beneficiaries. Jensen told the board, “We are so happy to be able to be here today talking about this contract to open up access for Medi‑Cal beneficiaries.” Dr. Mikaela Flodersen, who runs a children’s IOP program, said clinical outcomes at her program show “meaningful improvement” and high completion rates.

The hearing included sustained questioning from supervisors about logistics. Foley asked whether services would be provided within seven days of hospital discharge as the RFP allowed; county staff said seven days is the outside limit and the intention is to provide services sooner. Supervisors also pressed providers on the ability to offer evening and weekend sessions and on transportation for patients who live far from the planned clinic sites.

Charlie Health, a national virtual IOP provider, sought to be considered on the adult side and argued that a virtual model can increase access. Chris McClellan, Charlie Health’s chief commercial officer, said their model reaches patients who cannot travel, noting, “95 percent of patients who come through our care are not readmitted to a higher level of care.” County staff and medical leaders replied that Medi‑Cal billing rules require some in‑person clinical capacity for IOP and that telehealth may be an allowable augment but not a full replacement for in‑person services.

Anaheim Community Hospital said it will provide transportation for patients who cannot reach clinic sites and indicated it is prepared to expand hours and weekend slots if needed. Glenn Rauppen, CEO of Anaheim Community Hospital, told supervisors the hospital will “arrange” transportation and absorb the cost initially to ensure access.

The board approved CHOC’s award for children (motion by Supervisor Wynne, seconded on the floor). Supervisors Winn, Foley and Wagner voted aye; Supervisors Sarmiento and Chair Chaffee voted no. The remaining adult contracts were continued to the board’s November meeting for staff to provide detailed scoring breakdowns, options for telehealth/partnership with virtual providers and plans for transportation and geographic access.

Next steps: staff will return with the evaluation detail, any recommended subcontracting approvals and options for adding telehealth capacity within Medi‑Cal billing rules. The board directed staff and the recommended providers to explore partnerships that could expand weekend and evening access and to report back at the November meeting.