REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 29, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contract with Crest Home for The Elderly for Enhanced Assisted Living Program Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1, effective March 29, 2022, to Contract No. 20-865 with Crest Home for The Elderly for the provision of Enhanced Assisted Living Program Services to adult and older adults who are high utilizers of acute medical and psychiatric care, updating standard contract language, increasing the annual number of beds days from 1,825 to 3,650, and increasing the total contract amount by $1,916,250, from $2,555,000 to $4,471,250, with no change to the contract period of August 25, 2020 through June 30, 2025.
(Presenter: Georgina Yoshioka, Interim Director, 388-0801)
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 increased amount of $1,916,250 for Enhanced Assisted Living Program Services is funded by Mental Health Services Act (MHSA) funding. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2021-22 recommended budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
The Enhanced Assisted Living program provides unlocked Assisted Living Facilities that are licensed and governed by the State of California, Community Care Licensing Division, providing 24/7 services to adult and older adults over the age of 50 who require care and supervision as well as assistance with performing their activities of daily living. Crest Home for The Elderly (Crest Home) creates a safe and stable environment for adult and older adults who are high utilizers of acute medical and psychiatric care and affords the opportunity to divert placement into higher levels of care such as a Skilled Nursing Facility. The recommended contract amendment will allow services to be available for up to 10 beds and up to 3,650 bed days annually, at a rate of $280 per bed day.
Crest Home provides comprehensive medical care such as assistance in all activities of daily living, monitoring vital signs, wound care, medication management, and injections to those consumers who also experience a comorbid behavioral health condition and require support and monitoring to ensure their psychiatric stability. In addition, Crest Home’s two facilities, located in Norco, provide organized therapeutic activities for recreation, social interaction, and memory enhancement that promotes quality of life and improves functionality in daily living and social skills, preparing the consumers to return to a less structured facility when appropriate.
During 2020-21, Crest Home served five consumers, providing enhanced assisted living services and maintaining consumers in the least restrictive level of care, therefore avoiding unnecessary psychiatric hospitalization, which reflects a considerable cost savings to San Bernardino County. The DBH contracted beds are at full capacity and there is a need for additional beds as there has been an increase of consumers being referred. There were 31 referrals for consumers to be transitioned from State Hospitals into lower levels of care during this fiscal year. The increase of five additional beds, for up to 10 beds total will allow DBH to accommodate more of these consumers transitioning to the lower level of care.
PROCUREMENT
On August 25, 2020 (Item No. 17), the Board of Supervisors approved the non-competitive contract with Crest Home for the provision of Enhanced Assisted Living program services, in the amount of $2,555,000, for a period of August 25, 2020 through June 30, 2025. DBH does not procure for these services as there are a limited number of state licensed Enhanced Assisted Living facilities offering the necessary acute level of care with available beds willing to provide services to DBH clients. DBH would be willing to facilitate future solicitations providing resources become available.
DBH will monitor contract performance on a regular basis to ensure performance and compliance standards are met by reviewing monthly reports, ongoing site visits to review consumer progress, as well as an annual program review. Crest Homes’ invoices will be reviewed and approved by DBH Programs to ensure clients and bed count are accurate prior to being forwarded to Fiscal for payment. Fiscal will verify signatures, bed rate and total cost prior to issuing payment.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on February 23, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 7, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393) on March 15, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on March 15, 2022.