REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
August 20, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Contracts for Mental Health Rehabilitation Center Services
End
RECOMMENDATION(S)
Recommendation
Approve contracts with the following agencies for Mental Health Rehabilitation Center services, in the total amount of $39,730,164, for the contract period of August 20, 2024 through September 30, 2029:
1. Crestwood Behavioral Health, Inc., in the contract amount of $26,312,512 and an additional aggregate amount of $13,417,652.
2. Telecare Corporation, in the aggregate amount of $13,417,652.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The total amount of both contracts in the amount of $39,730,164 for Mental Health Rehabilitation Center (MHRC) services is funded by 1991 Realignment revenue. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder (SUD) services to county residents experiencing severe mental illness and/or SUD. MHRCs are locked, long term licensed residential facilities serving adults aged 18 to 65. They are categorized as an Institution for Mental Disease providing services to individuals who suffer from a severe and chronic behavioral health condition and whose functioning is too low to be maintained in a licensed board and care facility. MHRCs provide a facility for high utilizers of acute psychiatric hospitals and the opportunity for continued stabilization as a step-down from an acute psychiatric hospital setting.
MHRCs specialize in providing comprehensive organized therapeutic activities, including skill building, small therapy groups, individual therapy, physical and recreational activities, and various types of supervised outings that include passes and special events designed to promote improved functionality in daily living and social skills. MHRCs prepare the individual to return to a less structured facility when appropriate such as a licensed board and care with enhanced services.
DBH clients requiring a locked, structured residential setting placement such as an MHRC are challenging to place as San Bernardino County lacks adequate facilities of this type. DBH continuously seeks local or in-close proximity MHRC providers willing to provide services to its clients. Placement of clients in MHRCs offer an appropriate level of care which is less costly to the County than other options for treatment.
In 2023-24 DBH utilized one MHRC, Crestwood Behavioral Health, Inc., which served a total of 44 clients. Upon approval of this item, DBH will have guaranteed access to 25 beds at Crestwood Behavioral Health, Inc. for current clients residing at the facility at a cost of $26,312,512. The remaining $13,417,652 will be allocated as needed between the two recommended providers once the 25 guaranteed beds are fully utilized. The total cost of MHRC services will not exceed $39,730,164 for the period of August 20, 2024, through September 30, 2029.
DBH will implement mechanisms to regularly review 1) client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) applicable claims data and claims for reimbursement to ensure fidelity and accuracy of service billing and optimization of Medi-Cal reimbursement in alignment with Contract terms and Department of Health Care Services billing requirements; and 3) provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
On April 4, 2024, the County Administrative Office approved the release of Request for Proposals (RFP) No. DBHE24-ADMN-5362 through the Electronic Procurement Network (ePro), to solicit interested and qualified organizations and agencies to provide MHRC services. The RFP was publicly advertised in local newspapers and sent through direct mailings to more than 600 community-based organizations, service providers, and other interested parties.
A bidder’s conference was held on May 2, 2024. Three proposals were received in response to the RFP by the established deadline. All three proposals, received from the agencies listed below, met the minimum requirements and were reviewed during the evaluation process:
|
Agency |
|
Crestwood Behavioral Health, Inc. |
|
SunBridge Shandin Hills Rehabilitation Center, LLC |
|
Telecare Corporation |
The evaluation committee, comprised of five individuals with representation from Office of the Public Guardian; Helping Hearts California, LLC; and DBH evaluated the proposals based on the criteria referenced in the RFP. The evaluation criteria included, but were not limited to: ability to serve the target population, proposed program services and strategies, ability to service the necessary number of unduplicated participants, readiness to provide services, experience, staffing levels and qualifications, appropriateness of facility (in Geographic Service Option/area, proximity to mass transit, facility layout, laundry/shower facilities, etc.), ability to serve specific geographic area, and the ability to measure outcomes.
Based on the evaluation results of the proposals, all three agencies were selected to be recommended for award. However, after being selected, SunBridge Shandin Hills Rehabilitation Center, LLC notified DBH it is in the process of applying for licensure as Shandin Hills MHRC, LLC (Shandin Hills). DBH will return to the Board of Supervisors at a later date to recommend Shandin Hills for award once the MHRC licensure is complete and the facility is in operation. Crestwood Behavioral Health, Inc. and Telecare Corporation are recommended for award at this time and will be ready to provide services by the contract start date.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Lisa Rivas-Ordaz, Contracts Supervisor, 386-8264) on July 23, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 26, 2024; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on July 26, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on July 30, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on August 5, 2024.