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
Amendment to Contract with Valley Star Behavioral Health, Inc for Crisis Walk-In Center Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 20-156, effective April 15, 2024, with Valley Star Behavioral Health, Inc. for the provision of Crisis Walk-In Center services, expanding mobile crisis response services, increasing the contract amount by $891,682, from $25,008,028 to $25,899,710, with no change to the total contract period of April 1, 2020, through March 31, 2025.
(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 recommended increase of $891,682 with Valley Star Behavioral Health, Inc. (Valley Star) for expanded Crisis Walk-In Center (CWIC) services is funded by Federal Financial Participation Medi-Cal and Mental Health Services Act funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 budget.
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. As the Mental Health Plan for the County, DBH provides authorization and oversight for inpatient and outpatient specialty mental health services and is required to provide a range of behavioral health services, such as CWIC services, to County residents. The CWIC program is a community-based alternative to unnecessary emergency department utilization, psychiatric hospitalization, or incarceration. DBH has provided CWIC services to County residents through contracted agencies since 2007.
On March 24, 2020 (Item No. 18), as a result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 20-156 (Contract) with Valley Star for CWIC services, in the amount of $17,109,956, for the period of April 1, 2020, through March 30, 2024.
The CWIC program provides urgent mental health services 24 hours a day, 7 days a week, to individuals of all ages who are experiencing a mental health crisis. The program targets unserved, underserved, and inappropriately served populations to reduce unnecessary treatment, incarceration, and recidivism. CWIC services are provided by multidisciplinary professional staff including, but not limited to, clinical therapists, licensed vocational nurses, peer advocates, and psychiatrists. CWICs provide crisis stabilization, a bundled mental health service that includes, but is not limited to, crisis intervention, risk assessment, case management, and medication support, when necessary.
Through Valley Star’s Crisis Mobile Response Team, Valley Star provides field-based crisis responses in the High Desert, West Valley, and East Valley regions of the county. Calls are answered in the DBH Crisis Contact Center, and, when needed, field responders are dispatched to the consumer’s location to provide support during the crisis. Department of Health Care Services (DHCS) Behavioral Health Information Notice (BHIN) 23-025 required DBH to implement certain requirements for a new Medi-Cal mobile crisis service benefit, which included 24/7 mobile response availability.
Due to the significant similarities between CWIC services and Mobile Crisis Response services, on December 19, 2023 (Item No. 22), the Board approved Amendment No. 1 to the Contract, adding Mobile Crisis Response services into the CWIC program, increasing the Contract amount by $7,898,072, from $17,109,956 to $25,008,028, and exercising the final extension for the total Contract period of April 1, 2020, through March 31, 2025, achieving DBH compliance with BHIN 23-025.
Approval of Amendment No. 2 (Amendment) will revise the scope of work to include transportation to an appropriate level of care or treatment center and hospital sit parameters, which is where the provider is expected to stay with an individual placed on an involuntary hold until admitted to a psychiatric unit, and extended contractor Mobile Crisis Response service hours from 6 p.m. to 8 a.m., providing an additional two hours of overnight coverage in order to meet the need for services.
The recommended Amendment with Valley Star will provide Mobile Crisis Response services to approximately 142 clients or individuals for the duration of the Contract period at an estimated cost of $6,253 per client.
DBH is requesting approval for this Amendment retroactive to April 15, 2024 due to the need to recruit and train staff necessary to provide these expanded services. This item is being presented at this time as it is the first available Board date following the completion of the required DBH program, fiscal, administrative, and legal reviews.
DBH will also 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 DHCS billing requirements; and 3) provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Lisa Rivas-Ordaz, Contracts Supervisor, 386-8264) on July 24, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 26, 2024; Finance (Paul Garcia, Administrative Analyst, 386-8392) on August 2, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on August 5, 2024.