Chair Lee on CBO contract assessment and service delivery models

In terms of contracts or savings, DOHMH has one of the agencies that has a really large number of contracts.

And just wanted to know how often does DOHMH assess the effectiveness of its programs run by CBOs, nonprofits?

Yeah.

Let me ask, Chair, is this related to EO12?

Or just broadly speaking, our contract re-evaluations?

I think in general, but yes.

I mean, the savings portion, yes, it's related to that.

But also in general, I think for best practices.

Yeah, how often we do it.

So, yeah, let me start on the savings piece, the EO12 piece, and then I'll get to Aaron to show a little bit more here.

So similar to our mandate with regard to public health, you know, we're trying to balance these two priorities.

The first is really L.

aligning with the mayor's vision on the chief savings officer initiative.

At the same time, we're making sure to not cut any services with regard to our mental hygiene portfolio.

And I'm proud to say that we've come through this process with EO12, and I can stand firmly here and say that no programs

were cut and no services were degraded as part of that experience.

Let me hand it to Aaron to share a little bit more.

Yeah, thanks Commissioner and thanks Chair Lee.

I mean as a general matter all CBOs are evaluated once a year at least.

Right, for the contract renewal?

Yeah.

Even if it's a three to five year contract that they still sort of have the annual?

Okay.

Yeah.

And I mean, aside from that, and I would certainly defer to my programmatic colleagues beyond this, but I mean, I think we're always thinking about metrics and how to make programs better and how they're doing and all of that good stuff.

Okay, perfect.

And are there service or program areas based on what you've done with the assessment that would function better if they were delivered by DOHMH directly?

And this is not just specifically related to the CBO contracts, but in general.

I guess you're asking the question of whether or not it's better for us to bring the services internal versus in-house, right?

Yeah, yeah, it's a really good question.

I'm going to pass it over to Dr.

Petit in a second.

But yeah, I think this is the core tension, not just on the mental health side, but also on the public health side, right?

What do we keep in-house?

And what do we, you know, sort of contract out and find a service delivery partner for?

So getting that right is something that we're constantly trying to improve on.

And so let me share it, hand it over to Dr.

Petit to share a little more.

Yeah, thank you, Commissioner.

Thank you for that question.

You know, as a public sector psychiatrist doing this for 30 years, it is an interesting question to be thinking about where the role of, you know, the division is vis-a-vis the providers.

But I do have to say, you know, the way that the entire system has been sort of built up over the last, you know, many decades is really relying on contracted providers who are deeply embedded in their communities, who know their communities

in ways that it's harder for us centrally to be as attuned to some of those needs.

Even though we're aware of them, it really is important for these niche providers to be able to deliver an array of services in their communities to their constituents a little bit differently than we could.

There are things that we could do citywide that are more overarching that really speak to the system as a whole.

But I am a big believer that a lot of our programs that exist in these communities are best served by community-based providers.

And as a former provider, I fully subscribe to that, especially in communities that have very specific language needs and cultural needs, so yes.