REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
August 20, 2019
FROM
VERONICA KELLEY, Director Department of Behavioral Health
SUBJECT
Title
Contract with Crestwood Behavioral Health, Inc. for Mental Health Rehabilitation Center Adult Residential Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve contract with Crestwood Behavioral Health, Inc. to provide adult residential treatment services within a locked Mental Health Rehabilitation Center, in an amount not to exceed $11,001,100, for the period of August 20, 2019 through August 19, 2024.
(Presenter: Veronica Kelley, 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). The amount of $11,001,100 ($2,200,220 annually) for these adult residential treatment services will be funded by 1991 Mental Health Realignment funding. Adequate appropriation and revenue have been included the Department of Behavioral Health’s (DBH) 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Mental Health Rehabilitation Centers (MHRC) are locked, long term residential facilities categorized as an Institute of Mental Disease (IMD) and considered a step towards less structured care. MHRCs provide services to consumers who suffer from a severe and chronic behavioral health condition and whose functioning is improving enough to move from a State Hospital or IMD but still too low to be maintained in a licensed board and care facility, including augmented board and care. MHRCs maintain a stable environment for high utilizers of acute psychiatric hospitals; this subacute facility benefits the consumer as it affords the opportunity for increased stabilization. The recommended contract with Crestwood Behavioral Health, Inc. (Crestwood) MHRC, with facilities in Bakersfield and Fallbrook, will allow DBH to expand the variety of adult residential treatment services in order to meet the increased need of consumers who are ready for this level of care rather than the more costly acute psychiatric hospitals.
MHRCs are licensed facilities serving adults age 18 to 59, specializing in providing comprehensive organized therapeutic activities, including skill building, small therapy groups, individual therapy, physical and recreational activities, and various types of supervised outings that include passes and special events designed to promote improved functionality in daily living and social skills, preparing the consumers to return to a less structured facility when appropriate.
DBH consumers requiring a locked, structured residential setting placement like an MHRC are challenging to place as San Bernardino County area is currently without MHRC facilities. DBH continuously seeks local MHRCs or in-close proximity providers willing to provide locked long term residential services to our consumers. Recently, Crestwood announced a new MHRC facility in Fallbrook opening in 2019 and DBH was able to secure 15 beds pending contract approval as well as place one additional consumer in an available bed in Bakersfield. These will be the first MHRC facilities to offer services to DBH consumers at a step below a State Hospital, expanding DBH residential continuum of care.
Under the terms of the recommended contract, DBH will utilize Crestwood’s locations in Bakersfield and Fallbrook to access 16 beds, which will provide 5,840 bed days annually, with an average length of stay nine to sixteen months. It is anticipated approximately 16 to 32 consumers will be served by Crestwood at an estimated annual cost per consumer ranging from $68,756 to $137,513 dependent upon the individual need for services.
PROCUREMENT
DBH does not procure for these services as there are a limited number of state licensed MHRC facilities with available beds willing to provide services to DBH consumers. In order to address the continuing need for these locked facilities providing adult residential treatment services, DBH is recommending a non-competitive contract with Crestwood as they are willing to accept DBH consumers with locations in close proximity to San Bernardino County. Purchasing concurs with the non-competitive justification of specialized mental health treatment services.
DBH will monitor contract performance on a regular basis to ensure performance and compliance standards are met.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health (Natalie Kessee, Contracts Manager, 388-0869) on July 24, 2019; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on July 24, 2019; Purchasing (Leo Gomez, Purchasing Manager 387-2063) on July 26, 2019; Finance (Christopher Lange, Administrative Analyst, 386-8393) on July 31, 2019; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on July 31, 2019.