REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 25, 2024
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Contract with Star View Behavioral Health for Youth in Residential Placement
End
RECOMMENDATION(S)
Recommendation
Approve Contract with Star View Behavioral Health, Inc. for the provision of Youth in Residential Placement services, in the amount of $6,500,000, for the contract period of July 1, 2024, through June 30, 2029.
(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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The recommended contract for $6,500,000 with Star View Behavioral Health, Inc. (Star View) for Youth in Residential Placement (YRP) services is funded by Federal Financial Participation Medi-Cal and 2011 Realignment funds. 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 San Bernardino County (County) residents experiencing severe mental illness and/or SUD. Star View maintains two State licensed facilities: a Psychiatric Health Facility (PHF) and a Community Treatment Facility (CTF) that provide mental health services to children and youth in residential placement that have complex diagnoses, require a higher level of treatment, and require 24 hours a day seven days a week care in a secured (locked) setting. Children and youth who are seriously emotionally disturbed and demonstrate the need for this level of care are referred by the County Department of Children and Family Services, the County Probation Department, and DBH, then further screened and evaluated by the County Interagency Placement Council.
Star View maintains a full continuum of mental health services to individuals ages 12-20 (up to youth’s 21st birthday) with serious mental health problems at home and/or school. Seriously emotionally disturbed children and youth placed in these facilities have had multiple placements and/or are currently in a psychiatric hospital and the only alternative would be an out-of-state placement. Star View’s PHF is licensed by the California Department of Health Care Services and is federally certified or licensed by a nationally recognized commission. Star View’s CTF is a residential treatment facility that provides mental health treatment services to children and youth diagnosed with serve mental illness providing a safe environment that enables children/youth with mental health needs to receive treatment in less restrictive, more appropriate settings, closer to their families’ homes. The CTF is licensed by the California Department of Social Services.
The estimated monthly cost of a child or youth in placement may be up to $38,316 in the PHF and up to $15,927 in the CTF. Typically, a child or youth is placed in the PHF for stabilization purposes and once stablized, is transitioned to the CTF for additional services. DBH anticipates that Star View will provide YRP services to approximately six unduplicated clients annually at an estimated average cost of $216,667 per child or youth. The average length of stay per client is nine months.
Assembly Bill (AB) 1051, passed in 2021, revised state law concerning presumptive transfers. Amended by AB 551 to start July 1, 2024, the “presumption” of responsibility for arranging for and providing Specialty Mental Health Services (SMHS) will remain with the placing county unless certain conditions are met. Although the County has maintained fiscal responsibility for children and youth placed at Star View since 2009, the passage of AB1051 mandates that fiscal responsibility.
DBH will also implement mechanisms to regularly 1) review client service data and progress, conduct site visits and annual monitoring to ensure performance and compliance standards of the contract(s) are met; 2) review applicable reimbursement claims and claims data 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) review provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
DBH does not conduct a formal procurement for these specialty mental health placement services as there are only two agencies in the State that provide this level of service to this population. DBH has contracted with this agency through non-competitive contract agreements since 2009, as approved by Purchasing. There is a need for the level of service that PHF and CTF provide, and Star View is the only agency licensed to operate both types of facilities. Purchasing concurs with the non-competitive justification of the services as specialized services.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Ellayna Hoatson, Contract Supervisor, 388-0858) on June 6, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on June 11, 2024; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on June 12, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on June 13, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on June 13, 2024.