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 Contracts for Adult Residential Facilities with Social Rehabilitation Treatment Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2 to Contract No. 21-61, effective October 11, 2023, with Amethyst Behavioral Health, LLC for the provision of Adult Residential Facilities with Social Rehabilitation Treatment services, revising the Statement of Work, updating standard contract language, increasing the amount by $1,576,800, from $5,025,180 to $6,601,980, and exercising the last option to extend the contract an additional year, for the total contract period of February 1, 2021 through June 30, 2025.
2. Approve Amendment No. 4 to Contract No. 20-608, effective October 11, 2023, with Helping Hearts California, LLC for the provision of Adult Residential Facilities with Social Rehabilitation Treatment services, revising the Statement of Work and updating standard contract language, with no change to the contract amount of $36,749,300 or the contract period of July 1, 2020 through June 30, 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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The recommended increase of $1,576,800 to the contract for the Adult Residential Facilities (ARF) with Social Rehabilitation Treatment (SRT) services is funded by Federal Financial Participation Medi-Cal and the Mental Health Services Act. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget and will be included in the 2024-25 recommended 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. Since 2016, DBH has utilized the ARF with SRT model to provide services for adults experiencing a behavioral health condition who no longer meet medical necessity for an acute psychiatric hospital, or who have reached treatment goals in a locked psychiatric residential facility.
Treatment and assessment services in the ARF with SRT model include group and individual therapy, crisis intervention, case management, and coordinated care including transportation for medical and psychiatric services outside of the facility. As clients continue to progress in their recovery and begin to work towards the goal of living independently in the community, additional community-based activities, events, education, and other support services for daily living are incorporated into their service plan that will enhance skills for independent living (i.e., proper medication regime, social skills, financial management/budgeting, and family reconciliation) in a less restrictive environment. Daily living services are designed to assist the client with achieving independence.
These ARFs are utilized as an initial consideration or a step down from the more costly acute psychiatric hospitalization or locked residential facilities and have access to long-term as well as transitional SRT depending on the needs of the individual client. The current contracts require the County to compete with other counties and private clients for access to the 66 beds, which include 12 beds at Amethyst Behavioral Health, LLC (Amethyst) and 54 beds at Helping Hearts California, LLC (Helping Hearts). The recommended amendments will reserve all 66 beds for exclusive use by the County. DBH anticipates that Amethyst will serve approximately 24 clients annually at an estimated cost of $65,700 per client and Helping Hearts will serve approximately 108 clients annually at an estimated cost of $82,125 per client.
Approval of Amendment No. 2 to Contract No. 21-61 with Amethyst will update standard contract language (Funding and Budgetary Restrictions, Duration and Termination, Iran Contracting Act, Executive Order N-6-22 Russia Sanctions, and Campaign Contribution Disclosure [Senate Bill 1439 (SB 1439)], update the Referenced Contract Provisions (Term, Maximum Obligation and Payment/Reimbursement Rate), revise the Statement of Work, update the 2023-24 and add 2024-25 Budget Schedules, increase the contract amount by $1,576,800, from $5,025,180 to $6,601,980, and exercise the last option to extend the contract an additional year, for the total contract period of February 1, 2021 through June 30, 2025.
Approval of Amendment No. 4 to Contract No. 20-608 with Helping Hearts will update standard contract language (Iran Contracting Act, Executive Order N-6-22 Russia Sanctions, and Campaign Contribution Disclosure (SB 1439), update the Referenced Contract Provisions (Payment/Reimbursement Rate), revise the Statement of Work, update the 2023-24 and 2024-25 Budget Schedules, with no increase to the contract amount of $36,749,300, or change to the contract period of July 1, 2020 through June 30, 2025.
This item is being presented at this time as DBH has identified the need to reserve all 66 ARF SRT beds specifically for DBH clients to increase capacity in preparation for upcoming mandated programs, including Assisted Outpatient Treatment (also known as Laura’s Law) and the Community Assistance, Recovery and Empowerment (CARE) Act. The contractors have requested to be paid for the beds whether vacant or filled, effective October 11, 2023.
DBH will continue to monitor contract performance on a regular basis to ensure performance and compliance standards are met. Invoices will be reviewed and approved in a timely manner. DBH’s fiscal staff will verify signatures, and total cost prior to submission for payment.
PROCUREMENT
On July 28, 2020 (Item No. 22), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 20-608 with Helping Hearts for the provision of ARF with SRT services, in the amount of $6,168,500, for the period of July 1, 2020 through June 30, 2021, with four one-year extension options contingent upon funding and contractor performance.
On January 26, 2021 (Item No. 24), as the result of a formal procurement, the Board approved Contract No. 21-61 with Amethyst for the provision of ARF with SRT services, in the amount of $4,855,500, for the period of February 1, 2021 through June 30, 2024.
On January 26, 2021 (Item No. 25), the Board approved Amendment No. 1 to Contract No. 20-608 with Helping Hearts, increasing the total contract amount by $6,059,000, from $6,168,500 to $12,227,500, and extending the contract one-year, for the total contract period of July 1, 2020 through June 30, 2022.
On May 24, 2022 (Item No. 35), the Board approved Amendment No. 2 to Contract No. 20-608 with Helping Hearts, increasing the total contract amount by $6,059,000, from $12,227,500 to $18,286,500, and extending the contract one-year, for the total contract period of July 1, 2020 through June 30, 2023.
On March 28, 2023 (Item No. 19), the Board approved Amendment No. 3 to Contract No. 20-608 with Helping Hearts. The amendment updated the contract language, increasing the bed rate and bed count from 40 to 54, increased the total contract amount by $18,462,800, from $18,286,500 to $36,749,300, and extended the contract two-years, for the total contract period of July 1, 2020 through June 30, 2025.
On May 23, 2023 (Item No. 24), the Board approved Amendment No. 1 to Contract No. 21-61 with Amethyst, increasing the daily bed rate by $35 from $325 to $360, due to inflation and increasing the total contract amount by $169,680, from $4,855,500 to $5,025,180, with no change to the contract period of February 1, 2021 through June 30, 2024.
As this will be the final extension for these services, a new procurement will be conducted in 2024-25 with services to begin July 1, 2025.
REVIEW BY OTHERS
This item has been reviewed by (Ellayna Hoatson, Contracts Supervisor, 388-0858) on February 29, 2024; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on March 5, 2024; Finance (Christopher Lange, Administrative Analyst, 386-8393) on March 8, 2024; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on March 11, 2024.