REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 5, 2023
FROM
GEORGINA YOSHIOKA, Director, Department of Behavioral Health
SUBJECT
Title
Amendment to Contract with Anne Sippi Clinic Treatment Group for Enhanced Board and Care Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 2 to Contract No. 19-236, effective July 1, 2023, with Anne Sippi Clinic Treatment Group for the provision of Enhanced Board and Care Treatment Services, updating contract language, with no change to the total contract amount of $3,239,375, or the contract period of July 1, 2019, through June 30, 2024.
(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 amount of $3,239,375 for Enhanced Board and Care Treatment Services is funded by 1991 Mental Health Realignment and the Mental Health Services Act. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2023-24 budget.
BACKGROUND INFORMATION
DBH is responsible for providing mental health and substance use disorder services to San Bernardino County (County) residents experiencing severe and persistent mental illness, substance use, and other addictions. Anne Sippi Clinic Treatment Group (ASC Treatment Group) is one of a select few State-licensed Board and Care providers who provide specialty mental health services at the highest level of enhanced treatment. The enhanced treatment services are utilized by consumers transitioning from a long term locked psychiatric residential facility such as State Hospitals and Institutions for Mental Disease, whose difficult behavior has impacted their ability to be placed into a traditional Board and Care and successfully transition into the community.
For adults living with a behavioral health condition who are discharging from long-term locked facilities and need intensive mental health case management to support their transition to the community, DBH provides care pursuant to Title 9, and Title 22 Division 6 of the California Code of Regulations (CCR), and Welfare and Institutions Code, Division 5. These enhanced treatment services include an intensive multimodal approach that is supportive and valuable in assisting the consumer to adjust and progress in their individual recovery out of a locked psychiatric facility. For DBH’s consumers suffering from a severe behavioral health condition, utilizing the enhanced level of care, at a significant cost savings, allows consumers to step out of a locked facility and better adapt to a residential setting with personalized treatment and programming designed for a successful community reintegration.
Since 2016, ASC Treatment Group has provided Enhanced Board and Care Treatment Services in a residential setting to DBH consumers at its two locations in Los Angeles and Bakersfield. Under the terms of the contract, ASC Treatment Group agrees to accept consumers that experience challenging behavior, including impulsivity and aggressiveness that local board and care facilities will not accept, providing 24 hours a day, seven days a week, 365 days a year, residential enhanced services to adults with severe behavioral health conditions. In addition to the board and care services that are required by Title 22 CCR, ASC Treatment Group provides specialized treatment services such as intensive outpatient services including medication support, life skills groups, individual therapy, psycho-educational groups, and community outings that are tailored to enhance everyday living skills to ensure community reintegration. ASC Treatment Group also provides recovery-oriented peer support programs, innovative treatment systems incorporating evidence-based practices and work-oriented programs in several languages, including staff proficient in American Sign Language.
The recommended amendment will update contract language to remove the specific rate and replace with the County authorized rate, with no change to the total contract amount and no change to the contract period of July 1, 2019, through June 30, 2024. It will also update funding and payment as well as adding Executive Order N-6-22 Russia Sanctions, and Campaign Contribution Disclosure language.
In April 2023, ASC Treatment Group requested a rate change starting in 2023-24. After an extensive analysis, DBH determined the rate change was appropriate, and would not affect the total contract amount, so approved the rate change on June 20, 2023. In July 2023, it was determined the additional language changes indicated above were necessary. In October 2023, DBH became aware of the need for retroactive approval to accommodate the change in the service rate. The amendment is being presented at this time as this is the first available date following the required operational, fiscal, and legal reviews.
Over the term of the contract, an average of 10 consumers have been served annually at a cost of $64,788 per consumer.
PROCUREMENT
In 2018, DBH conducted a thorough search for any new or existing facilities willing and able to provide care for consumers with these special needs within the County. The process included a file review of consumer history and needs assessment by any eligible licensed Board and Care facility with psychiatric treatment services. This search did not identify any new or existing facilities with the exception of ASC Treatment Group who has been successfully providing specialty mental health services to DBH’s consumers with complex and/or challenging behavior. Purchasing continues to concur with the non-competitive justification of these services as specialized services.
On April 30, 2019 (Item No. 27), the Board of Supervisors (Board) approved non-competitive Contract No. 19-236 with ASC Treatment Group for the provision of Enhanced Board and Care Treatment Services to DBH’s consumers with complex and/or challenging behavior, in the amount of $1,460,000, for up to five consumers per day, for the period of July 1, 2019, through June 30, 2024.
On December 14, 2021 (Item No. 21), the Board approved Amendment No. 1 to Contract No. 19-236 with ASC Treatment Group for the provision of Enhanced Board and Care Treatment Services updating contract language, increasing the total number of beds, and increasing the total contract amount by $1,779,375, from $1,460,000 to $3,239,375, with no changes to the contract period of July 1, 2019, through June 30, 2024.
DBH will continue to monitor contract performance on a regular basis to ensure performance and compliance standards are met. DBH performs on site reviews at least annually, as well as consumer and collateral visits monthly. At the annual review, all aspects of the contract are monitored. At the monthly reviews, consumer services, supports and progress are monitored. Fiscal staff verify signatures, and bed rates prior to submitting for payment.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on October 20, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on October 26, 2023; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on November 6, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on November 7, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on November 15, 2023.