REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 19, 2023
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. 1 to Contract No. 20-156 with Valley Star Behavioral Health, Inc. for the provision of Crisis Walk-In Center Services, integrating Mobile Crisis Response services, updating standard contract language, exercising the final option to extend contract period by one year, and increasing the total contract amount by $7,898,072, from $17,109,956 to $25,008,028, for the 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.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The total increase of $7,898,072 will be funded by Mental Health Services Act, Federal Financial Participation Medi-Cal, and 2011 Realignment. Adequate appropriation and revenue are 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, alcohol, and substance use disorder services to San Bernardino County (County) residents who are experiencing major mental illness, substance use disorder, and other addictions. 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 Crisis Walk-In Center (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. Valley Star Behavioral Health, Inc. (Valley Star) has provided these services since 2014 in the High Desert region and since 2015 in the Eastern Desert region.
Through the CWIC program, Valley Star provides urgent mental health services to severely mentally ill persons of all ages experiencing a mental health crisis, 24 hours a day, seven days a week. A professional staff of licensed therapists, clinicians, and vocational nurses provide crisis stabilization, a bundled service consisting of crisis intervention, crisis risk assessments, peer support, medication when necessary, and case management.
Currently, DBH provides Mobile Crisis Response from 7 a.m. to 10 p.m., 365 days per year through Community Crisis Services (CCS). CCS provides field and phone based mobile crisis response in the County. Calls are answered in the Crisis Contact Center and, when needed, field responders are dispatched to the consumer’s location to provide support during the crisis. Field responses are available to individuals in the West Valley, East Valley, and High Desert regions of the county. Telehealth, text, and telephone services are available to individuals countywide, including those in the Eastern Desert (Yucca Valley and the Morongo Basin) and Mountain regions. DBH, in consultation with the Purchasing Department, identified the opportunity to integrate overnight Mobile Crisis Response services into the CWIC program due to the significant similarities existing between the two services.
DBH anticipates that Valley Star will provide CWIC services to approximately 4,368 clients annually at an estimated cost of $1,116 per client. With the expansion to include Mobile Crisis Response services, Valley Star is expected to serve an additional 538 unduplicated consumers for the duration of this agreement at an estimated cost per client of $4,778.
On December 19, 2022, the Department of Health Care Services (DHCS) issued Behavioral Health Information Notice (BHIN) No. 22-064, which directs counties to implement Mobile Crisis Response services, consistent with specified criteria for a new Medi-Cal benefit, by no later than December 31, 2023. Specified criteria include, but are not limited to, availability of services 24 hours a day, seven days a week. BHIN 22-064 was later superseded by BHIN 23-025, issued June 19, 2023, which further clarified implementation and service requirements.
To meet the requirements of BHIN 23-025, DBH, in consultation with the Purchasing Department, determined Mobile Crisis Response services for the hours of 7 p.m. to 7 a.m., 365 days per year most closely aligned with the CWIC services provided through Contract No. 20-156 with Valley Star. DBH contacted Valley Star to determine their interest in providing the Mobile Crisis Response services for the hours of 7 p.m. to 7 a.m., 365 days per year for the West Valley, East Valley, and High Desert regions. CCS will continue to provide Mobile Crisis Response services from 7 a.m. to 7 p.m. and calls will continue to be routed through the Crisis Contact Center. Services will be dispatched out of the High Desert CWIC location with mobile response delivered throughout the West Valley, East Valley, and High Desert regions, and telehealth, text, and phone services to Eastern Desert and Mountain regions.
Approval of this amendment will update contract language, adding Executive Order N-6-22 Russia Sanctions, Campaign Contribution Disclosure (SB 1439), the scope of work allowing DBH to integrate Mobile Crisis Response services into the CWIC program, the CWIC services to be provided as well as improving the support they are to provide consumers, and exercise the option to extend the contract for one year, increasing the contract amount by $7,898,072 from $17,109,956 to $25,008,028 for the total contract period of April 1, 2020, through March 31, 2025.
On March 24, 2020 (Item No. 18), as the result of a formal procurement, the Board of Supervisors approved Contract No. 20-156 for CWIC services in the amount of $17,109,956 with Valley Star, for the period of April 1, 2020, through March 30, 2024.
DBH Program will monitor contract performance on a regular basis to ensure performance and compliance standards are met by reviewing monthly reports, ongoing data and utilization analysis, and annual program reviews. Electronic Health Record data will be reviewed regularly to ensure fidelity and accuracy of service billing and maximization of Medi-Cal reimbursement in alignment with contract terms. DBH Fiscal staff will verify signatures and service costs prior to issuing payment.
Amendment No. 1 will allow DBH Program to exercise the final extension until March 30, 2024 with a total contract amount of $25,008,028.
PROCUREMENT
As this will be the final extension for these services, a new competitive procurement will be conducted with services to begin April 1, 2025.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Ellayna Hoatson, Contract Supervisor, 388-0858) on November 30, 2023; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on December 1, 2023; Purchasing (Jessica Barajas, Supervising Buyer, 387-2065) on December 4, 2023; Finance (Christopher Lange, Administrative Analyst, 386-8393) on November 30, 2023; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on December 4, 2023.