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
Standard Agreement Template for Children’s Residential Intensive Services
End
RECOMMENDATION(S)
Recommendation
1. Approve the revised standard agreement template for ongoing Children’s Residential Intensive Services, updating contract language, to be used with current and future qualified agencies, with no change to the aggregate not to exceed amount of $53,000,000, upon the execution of the contract by parties through June 30, 2026.
2. Authorize the Assistant Executive Officer, Deputy Executive Officer, or Director of the Department of Behavioral Health to execute the individual standard agreement template with agencies which have successfully completed the standardized application process to become a Children’s Residential Intensive Services provider, on behalf of the County, subject to review by County Counsel.
(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 aggregate not to exceed amount of $53,000,000 for Children’s Residential Intensive Services (ChRIS) is funded by Federal Financial Participation Medi-Cal, 2011 Realignment, a Memorandum of Understanding with the Department of Children and Family Services (CFS), and Mental Health Services Act funds. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2024-25 budget and will be included in the 2025-26 recommended budget.
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. DBH is responsible for meeting the mental health needs of minors in its care by providing the necessary level of services to minors placed in residential care settings. DBH has been providing ChRIS to children requiring Specialty Mental Health Services (SMHS) in Short-Term Residential Therapeutic Programs (STRTPs) since 2010.
The ChRIS program is a structured residential program that uses STRTP’s and incorporates the practice principles and behaviors of the Integrated Core Practice Model (ICPM) to provide the required SMHS services to children and youth who are CFS dependents and/or Probation wards. ICPM is a team-based process, implemented in four phases: Engagement, Service Planning, Monitoring and Adapting, and Transition, establishing an authentic partnership with children, youth, and families which results in coordinated and integrated plans that are individualized to address the unique needs of each child and family member working together towards well-being and permanency. Services are available to eligible children and youth during the period of placement and up to two months after the child or youth have left the group home to facilitate a successful transition to a lower level of care.
STRTP’s provide short-term, high levels of specialized, and intensive mental health treatment services, as well as 24-hour care and supervision to children and youth who suffer from severe emotional and behavioral disorders in need of residential care, reduction in the use of congregate care placement settings, and the creation of more expeditious paths to permanency to reduce the duration of child’s involvement in the child welfare and juvenile justice systems.
The expectation is these SMHS will be integrated with the residential services provided by the direct care staff provided within an STRTP. Core services are provided, including community services; individualized enrichment activities; physical, behavioral, and mental health support; access to services including educational support, life and social support; transitional support services for children, youth, and families who assume permanency; services for transition-aged youth and non-minor dependents; and trauma-informed practices and support for children and youth, including treatment services. DBH anticipates that ChRIS providers will serve approximately 600 clients annually at an average cost of $17,666 per client.
ChRIS providers must meet strict licensing, accreditation, qualification, and program requirements to be part of DBH’s qualified provider pool. The California Department of Health Care Services (DHCS) expects DBH to have a contract approved within 30 days of notification from a qualified agency requesting to provide ChRIS. The revised standard agreement template will enable DBH to meet this expectation when qualified providers are identified.
The revised Standard Agreement Template will update standard contract language, adding Executive Order N-6-22 - Russia Sanctions, Campaign Contribution Disclosure (Senate Bill 1439) and revise the Scope of Work to include legislative changes with no change to the aggregate not to exceed amount of $53,000,000, or change to the contract period of date of execution through June 30, 2026. All current and future qualified providers will be required to execute the revised Standard Agreement Template.
DBH will also implement mechanisms to regularly 1) review client service data and progress, and 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 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) review provider invoices administratively and programmatically to ensure client and/or bed counts are accurate prior to payment processing.
On June 22, 2021 (Item No. 30), as the result of a formal procurement, the Board of Supervisors (Board) approved a standard agreement template for ongoing procurements to be used for the provision of ChRIS, in the aggregate not to exceed amount of $53,000,000, from the date of execution through June 30, 2026.
On May 24, 2022 (Item No. 42), the Board approved the revision to the standard agreement template for ongoing procurements to be used for the provision of ChRIS, with no change to the aggregate not to exceed amount of $53,000,000 or change to the contract period of date of execution through June 30, 2026.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Ellayna Hoatson, Contract Supervisor, 388-0858) on June 10, 2024; County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) 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.