REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 1, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Amendments to Contracts for Crisis Residential Treatment and Crisis Stabilization Unit Program Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 4, effective March 1, 2022, to the following contracts to provide Crisis Residential Treatment program services, updating program language, with no change to the total contract amount of $24,766,666 or the contract period of September 1, 2017 through June 30, 2022:
a. Telecare Corporation, Contract No. 17-709, no change to the contract amount of $12,383,333.
b. Valley Star Behavioral Health, Inc., Contract No. 17-710, no change to the contract amount of $12,383,333.
2. Approve Amendments, effective March 1, 2022, to the following contracts to provide Crisis Stabilization Unit program services, updating program language, with no change to the total contract amount of $51,300,000 or the contract period of October 1, 2017 through June 30, 2022:
a. Telecare Corporation, Amendment No. 4 to Contract No. 17-765, no change to the contract amount of $25,650,000.
b. Telecare Corporation, Amendment No. 3 to Contract No. 17-766, no change to the contract amount of $25,650,000.
(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). There is no change to the amount of $24,766,666 for Crisis Residential Treatment (CRT) and the amount of $51,300,000 for Crisis Stabilization Unit (CSU) program services, which are funded by Medi-Cal Federal Financial Participation, 2011 Realignment, and Mental Health Services Act funding. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2021-22 budget.
BACKGROUND INFORMATION
DBH, as the County's Mental Health Plan, provides behavioral health treatment services throughout San Bernardino County for individuals with severe and persistent mental illness. This has been a seamless system of care enabling residents to access behavioral health treatment services in all regions of San Bernardino County. The recommended amendments to the contracts for CRT and CSU program services will update program language to accurately reflect the County’s financial responsibility for security guard coverage with no change to the contract amounts or the contract periods previously approved by the Board of Supervisors (Board).
Recommendation No. 1
The DBH CRT programs in the West Valley and Eastern Desert regions have a capacity of 16 beds per site, specializing in providing crisis residential treatment for individuals aged 18 to 59 who have been diagnosed with mental health and co-occurring disorders. Crisis residential treatment is a bundled service which includes, but is not limited to, assessments, treatment plan development, collateral services, crisis intervention, medication support services, and individual and group therapy. The agencies in Recommendation No. 1 provide CRT program services to approximately 274 individuals per facility annually, at an estimated cost of $9,489 per individual.
Recommendation No. 2
The DBH CSU programs in the East and West Valley regions provide 24/7 services to individuals experiencing an acute psychiatric episode or crisis who will benefit from short-term (up to 23 hours, 59 minutes) crisis stabilization services as an alternative to hospitalization. Clients in the CSU receive referrals for appropriate follow-up services. CSUs have a maximum capacity of 20, with 16 spaces for adults aged 18 and older and four spaces for children and adolescents. Crisis stabilization is a bundled service which includes, but is not limited to, assessments, treatment plan development, collateral services, crisis intervention, medication support services, and individual and group therapy. Telecare Corporation (Telecare) provides CSU program services to approximately 4,600 individuals (3,680 adults and 920 adolescents) per facility annually, at an estimated cost of $1,173 per individual.
PROCUREMENT
Recommendation No. 1
On August 22, 2017 (Item No. 19), as the result of a formal procurement, the Board approved Contract No. 17-709 with Telecare for CRT program services in the West Valley region, in the amount of $12,083,333, and Contract No. 17-710 with Valley Star for CRT program services in the Eastern Desert region, in the amount of $12,083,333, both for the period September 1, 2017 through June 30, 2022.
On November 6, 2018 (Item No. 13), the Board approved Amendment No. 1 to Contract No. 17-709 and Contract No. 17-710, updating standard language with no change to the contract amounts or contract periods.
On June 9, 2020 (Item No. 16), the Board approved Amendment No. 2 to Contract No. 17-709, updating standard language and increasing the amount by $100,000, from $12,083,333 to $12,183,333 and Contract No. 17-710, updating standard language and increasing the amount by $100,000, from $12,083,333 to $12,183,333, with no change to the contract periods.
On June 8, 2021 (Item No. 26), the Board approved Amendment No. 3 to Contract No. 17-709, updating standard language and increasing the amount by $200,000, from $12,183,333 to $12,383,333 and Contract No. 17-710, updating standard language and increasing the amount by $200,000, from $12,183,333 to $12,383,333, with no change to the contract periods.
Recommendation No. 2
On September 26, 2017 (Item No. 11), as the result of a formal procurement, the Board approved Contract No. 17-765 with Telecare for CSU program services in the East Valley region in the amount of $25,650,000 and Contract No. 17-766 with Telecare for CSU program services in the West Valley region in the amount of $25,650,000, both for the period October 1, 2017 through June 30, 2022.
On November 6, 2018 (Item No.13), the Board approved Amendment No. 1 to Contract No. 17-765 and Contract No.17-766, updating standard language with no change to the contract amounts or contract periods.
On March 2, 2021 (Item No.13), the Board approved Amendment No. 2 to Contract No. 17-765 and Contract No. 17-766, updating standard language, adding access for services to children age 12 and under with no change to the contract amounts or contract periods.
On June 8, 2021 (Item No. 33), the Board approved a contract template Amendment with providers of Specialty Mental Health services in order to remove County Contract Rate (CCR) Provisions as a result of the COVID-19 Public Health Emergency. In addition, this item authorized the Assistant Executive Officer of Human Services (currently entitled the Assistant Executive Officer of Department Operations), Deputy Executive Officer of Human Services, or DBH Director to execute the contract template Amendment with the providers of Specialty Mental Health services. As a result, the DBH Director executed Amendment No. 3 to Contract No. 17-765 with Telecare to remove the CCR provisions with no change to the contract amount or contract period.
DBH will continue to monitor contractor performance on a regular basis to ensure compliance standards are met. Contract monitoring is inclusive of, but not limited to, site visits and assessments of policy, procedures, process implementation, and service delivery components, to ensure compliance with contract and applicable laws and regulations. The fiscal review ensures costs claimed are reasonable, allowable, and in compliance with related financial records and procedures. Additionally, as needed and appropriate, a review of Medi-Cal certification, related standards, and chart documentation may be completed.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on January 28, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on January 31, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393) on February 3, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on February 14, 2022.