REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 19, 2023
FROM
SHANNON D. DICUS, Sheriff/Coroner/Public Administrator
SUBJECT
Title
Amendments to Contracts for Administration of the Jail Based Competency Treatment Program
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to Revenue Contract No. 21-203 with the California Department of State Hospitals (State Agreement No. 20-79018-000) to administer a Jail Based Competency Treatment Program to County inmates at the West Valley Detention Center, increasing the maximum reimbursement amount by $7,292,304, from $61,160,260 to $68,452,564, and extending the term by six months, for a new total contract period of January 1, 2021 through June 30, 2024.
2. Approve Amendment No. 2 to Contract No. 21-204 with Liberty Healthcare of California, Inc. to provide evaluation and restoration of mental competency services to inmates declared incompetent to stand trial, increasing the cost by $2,878,949, from $21,283,119 to a new not to exceed total amount of $24,162,068, and extending the term by six months, for a new total contract period of March 1, 2021 through June 30, 2024, with the option to extend the term for one additional one-year period.
(Presenter: Ernie Perez, Deputy Chief, 387-3760)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
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
Approval of this item will not result in the use of additional Discretionary General Funding (Net County Cost). The total increase in revenue of $7,292,304, for a new total revenue amount of $68,452,564, from the California Department of State Hospitals (DSH) will reimburse the Sheriff/Coroner/Public Administrator (Department) for direct and indirect costs associated with administering the Jail Based Competency Treatment (JBCT) Program. Costs include the designated space, personnel, and services, including medication, for the daily care of patient inmates, for the period of January 1, 2021 through June 30, 2024.
The total increase of $2,878,949 to Contract No. 21-204 with Liberty Healthcare of California, Inc. (Liberty), for a new not to exceed total contract amount of $24,162,068, includes $2,303,159 for the provision of clinical personnel and services necessary to evaluate and restore mental competency of patient inmates admitted into the JBCT Program at West Valley Detention Center (WVDC), for the period of March 1, 2021 through June 30, 2024. Additionally, $575,790 is included to support an increase in the number of patient beds, up to 16, if requested by the County, for the period of January 1, 2024 through June 30, 2024.
All costs of the JBCT Program are funded through Contract No. 21-203 with DSH, and the revenue associated with this contract has been included in the Department’s 2023-24 Budget. The Department will also continue to hold seven currently unfunded JBCT Program positions vacant until the need for the positions and a new funding source has been identified.
BACKGROUND INFORMATION
DSH is responsible for restoring individuals that have been charged with a felony and were found to be incompetent to stand trial by the California Superior Court (Court) back to competency. Once an individual is committed to a DSH facility for treatment, the facility has 90 days to make a written report to the Court concerning the defendant’s progress toward restoration of mental competence. Currently, DSH has insufficient beds, creating lengthy waiting lists of jail inmates throughout the State who are in need of mental competency restoration services, including those in San Bernardino County.
To address this shortage, DSH has contracted with the Department since 2015 to provide continued access to WVDC to administer the JBCT Program and provide San Bernardino County inmates, as ordered by the Courts, with evaluation and restoration of competency treatment services similar to those provided in state mental hospitals. This program allows inmates to begin treatment sooner and significantly decreases the time these individuals remain incarcerated due to faster adjudication of their criminal charges.
On March 23, 2021 (Item No. 64), the Board of Supervisors (Board) approved Contract No. 21-203 with DSH, retroactively to January 1, 2021 through December 31, 2023, for a maximum reimbursement amount of $75,445,851; and Contract No. 21-204 with Liberty, retroactively to March 1, 2021 through December 31, 2023, for a maximum cost of $25,864,776.
In the Spring of 2023, the Department requested DSH reduce the number of beds in the JBCT Program from 146 to 64 by limiting patients to only San Bernardino County inmates. On July 11, 2023 (Item No. 45), the Board approved Amendment No. 1 to Contract No. 21-203 with DSH to reduce the number of beds to 64 with a corresponding reduction in the maximum reimbursement amount of $14,285,591 from $75,445,851 to $61,160,260, with no change to the period of January 1, 2021 through December 31, 2023. In the same Item, the Board approved Amendment No. 1 to Contract No. 21-204 with Liberty, reducing the contract amount by $4,581,657, from $25,864,776 to a new not to exceed total amount of $21,283,119, with no change to the period of March 1, 2021 through December 31, 2023, with the option to extend the term for two additional one-year periods.
Approval of Recommendation No. 1 will allow the Department to continue the JBCT Program with reimbursement from DSH, for 64 allocated beds in the WVDC sheltered housing unit for use by Liberty, and will provide office space, furniture and security for Liberty’s personnel. Routine inmate healthcare, including medications, will be provided through the Department’s existing pharmacy, medical records and medical service delivery systems. To meet the operational needs of this contract, the Department will maintain a combination of safety and professional employees assigned to the program. At the end of the contract, assuming no further renewals, the Department will transfer incumbents from DSH contract-funded positions to existing vacant budgeted positions or delete positions through attrition.
Approval of Recommendation No. 2 will allow for Liberty to continue the provision of a team of specialized detention facility licensed clinical personnel to work approximately 40 hours per week, and provide JBCT Program patient inmates with treatment services such as mental competency evaluation and restoration, mental illness management, prescription of psychotropic medications, physical/mental/social stimulation, and other components required by applicable State law and regulations. Additionally, Liberty’s personnel will continue to comply with the State’s reporting requirements on inmate patient progress.
PROCUREMENT
A six-month extension is requested for both the Liberty and DSH contracts while the Department negotiates new cost savings rate adjustments and revenue offsets for mental health services to the JBCT Program. The contract with DSH can be cancelled by DSH with a 30-day advance written notice or by the County with a 50-day advance written notice. The contract with Liberty includes two one-year options to extend the term provided that an extension of the County’s contract with DSH is approved. The contract with Liberty can be terminated by either party with a 30-day advance written notice.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Grace B. Parson, Deputy County Counsel, 387-5455) on November 14, 2023; Purchasing (Michael Candelaria, Lead Buyer, 387-2060) on November 15, 2023; Finance (Erika Rodarte, Administrative Analyst, 387-4919) on November 30, 2023; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on December 4, 2023.