REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 26, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contract with Generations Healthcare for Institution for Mental Disease Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1, effective April 1, 2024, to Contract No. 23-1087 with Generations Healthcare for the provision of Institution for Mental Disease services, reflecting the legal name change to Life Generations Healthcare LLC and updating contract language to include an additional program site, with no change to the aggregate contract amount of $40,904,090 or the contract period of September 26, 2023, through June 30, 2027.
(Presenter: Georgina Yoshioka, Director, 252-5142)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Promote the Countywide Vision.
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). Amendment No. 1 to Contract No. 23-1087 with Generations Healthcare to update the provider’s legal name and contract language to include an additional program site does not have a monetary impact. Institution for Mental Disease (IMD) services are funded by Local Share. Adequate appropriation and revenue are included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
As the Mental Health Plan for San Bernardino County (County), DBH is required to provide an adequate network of treatment providers to County beneficiaries through an array of behavioral health services. DBH operates a continuum of care system that consists of County operated clinics and contracted service providers delivering a variety of mental health treatment services within each geographic region of the county. The highest level of care is state hospitals and acute psychiatric units; the next highest level of care is provided through an IMD facility. IMD facilities provide a program consisting of organized therapeutic activities which promote daily living and social skills to County residents experiencing a severe and persistent behavioral health disorder.
IMD facilities are state licensed, locked, skilled nursing facilities that provide specialized treatment services to consumers experiencing a severe behavioral health disorder whose functioning level is too challenging to be maintained at a licensed board and care facility, including augmented board and care, or in the community. DBH contracted IMD facilities are responsible for:
• Maintaining state certification as a skilled nursing facility;
• Providing bed days (room and board) at the Department of Health Care Services specified rate(s);
• Evaluating and accepting referrals from state hospitals, veteran hospitals, county/private facilities, and other facilities or sources deemed appropriate by DBH;
• Providing psychiatric services, treatment, and support staff with specialized training; and
• Providing medication management, crisis intervention, and discharge planning.
On September 26, 2023 (Item No. 24), the Board of Supervisors approved Contract No. 23-1087 with Generations Healthcare in the aggregate amount of $40,904,090, effective September 26, 2023, through June 30, 2027.
Amendment No. 1 to Contract No. 23-1087 reflects the legal name change to Life Generations Healthcare LLC and contains specific contract language changes to include an additional program site, with no change to the aggregate contract amount of $40,904,090 or the contract period of September 26, 2023, through June 30, 2027. The Lakeside location was a Skilled Nursing Facility (SNF) but has developed further to provide IMD specialized treatment services and will allow for additional placement options. The four beds utilized for SNF neurobehavioral services at the Lakeside location will be reallocated to IMD specialized treatment services under the recommended contract amendment.
On March 4, 2024, DBH was notified that the correct legal name for Generations Healthcare is Life Generations Healthcare LLC. DBH was unaware that the legal name was incorrect until the provider’s review of the recommended contract amendment. There will be no change to the Employer Identification Number. The recommended amendment will allow the assignment of the contract to the parent company, Life Generations Healthcare LLC, and the assumption of the contracted services under the correct agency name.
DBH will continue to monitor contract performance on a regular basis to ensure performance and compliance standards are met by reviewing monthly reports, completing ongoing site visits to review consumer progress, as well as completing an annual program review. Provider invoices are reviewed and approved by DBH program staff to ensure consumer and bed counts are accurate prior to being forwarded to DBH fiscal staff for payment processing. Fiscal staff verify signatures, bed rate, and total cost prior to submitting for payments.
PROCUREMENT
DBH does not conduct a formal procurement for these services as there are a limited number of state licensed IMD facilities willing to provide services to DBH consumers. The IMD providers specialize in providing services to persistently mentally ill consumers with psychiatric needs, severe medical issues, and a criminal history that other facilities decline to admit. The Purchasing Department continues to support the non-competitive contracts for IMD services with the justification of specialized services.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on February 20, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 5, 2024; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on February 26, 2024; Finance (Christopher Lange, Administrative Analyst, 386-8393) on February 28, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on March 11, 2024.