REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
November 5, 2019
FROM
VERONICA KELLEY, Director Department of Behavioral Health
SUBJECT
Title
Amendment to Contract with Crestwood Behavioral Health, Inc. for Mental Health Rehabilitation Center Adult Residential Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve Amendment No. 1, effective November 5, 2019, to Contract No. 19-589 with Crestwood Behavioral Health, Inc. to provide adult residential treatment services within a locked Mental Health Rehabilitation Center, increasing access to 15 additional beds for a total of 30 beds, increasing the total contract amount by $11,853,375, from $11,001,100 to $22,854,475, with no change to the contract 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 increase in the amount of $11,853,375 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 facility benefits the consumer as it affords the opportunity for increased stabilization. The recommended amendment with Crestwood Behavioral Health, Inc. (Crestwood) MHRC, with facilities in Bakersfield and Fallbrook, will allow DBH to increase the number of available beds for clients that are ready to be transitioned into an MHRC level care from a State Hospital or acute psychiatric facility. These clients have achieved some stabilization however still require the next level of care to ensure community integration and stabilization.
Since August 2019, DBH has placed 16 clients with Crestwood MHRC but are in need of access to additional beds. The services provided are 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.
Under the terms of the recommended amendment, DBH will utilize Crestwood’s locations in Fallbrook to access an additional 15 beds, which will provide 5,475 bed days annually, with an average length of stay nine to sixteen months. It is anticipated approximately 15 to 30 additional clients will be served annually at Fallbrook MHRC at an estimated annual cost per client ranging from $68,756 to $137,513, dependent upon the individual need for services.
PROCUREMENT
On August 20, 2019 (Item No. 18), the Board of Supervisors approved non-competitive Contract No. 19-589 with Crestwood Behavioral Health, Inc. for MHRC residential service, in an amount not to exceed $11,001,100, for the period of August 20, 2019 through August 19, 2024. 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 clients.
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 (Ellayna Hoatson, Contracts Supervisor, 388-0858) on October 17, 2019; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on October 17, 2019; Finance (Christopher Lange, Administrative Analyst, 386-8393) on October 18, 2019; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on October 18, 2019.