REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
June 9, 2020
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title v
Amendment to Contracts for Crisis Residential Treatment Program Services
End
RECOMMENDATION(S)
Recommendation
1. Approve Amendment No. 2, effective June 9, 2020, to the following contracts for the provision of Crisis Residential Treatment program services, increasing the total contract amount by $400,000 from $49,374,999 to $49,774,999, with no change to the total contract period:
a. Telecare Corporation, Contract No. 17-709, increasing the total contract amount by $100,000, from $12,083,333 to $12,183,333, for the period of September 1, 2017 through June 20, 2022.
b. Valley Star Behavioral Health, Inc., Contract No. 17-148, increasing the total contract amount by $200,000, from $25,208,333 to $25,408,333, for the period of April 4, 2017 through June 20, 2022.
c. Valley Star Behavioral Health, Inc., Contract No. 17-710, increasing the total contract amount by $100,000, from $12,083,333 to $12,183,333, for the period of September 1, 2017 through June 20, 2022.
2. Approve Amendment No. 1, effective June 9, 2020, to Contract No. 17-295 with Valley Star Behavioral Health, Inc., for the provision of Transitional Age Youth, Crisis Residential Treatment program services, increasing the total contract amount by $100,000, from $12,500,000 to $12,600,000, with no change to the total contract period of July 1, 2017 through June 20, 2022.
(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 $500,000 for 2019-20 Crisis Residential Treatment (CRT) and Transitional Age Youth (TAY) CRT program services will be funded by a combination of Medi-Cal Federal Financial Participation, 2011 Realignment and Mental Health Services Act). Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2019-20 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
DBH, 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 the County. The recommended amendments to the contracts for CRT and TAY CRT program services will add funds for 2019-20 as a result of an increase need by consumers for these residential treatment services, with no change to the contract period.
Recommendation No. 1
The CRT facilities are located in the East Valley, West Valley, High Desert and Eastern Desert regions are comprised of 16 adult beds per site, specializing in providing crisis intervention for individuals diagnosed with mental health and co-occurring disorders. CRT program services were initially estimated to provide 14 to 28 days of residential treatment services per consumer to achieve stability and regain optimum wellness. However, the days of residential treatment services is currently averaging 38 days of service per consumer. In addition, the preliminary budget for the four CRT programs estimated a bed utilization rate of 90% for each location.
DBH’s analysis of the CRT facilities utilization rate since opening has shown the programs are maintaining an average of 93% utilization, and costs associated with these utilization rates have therefore increased, such as an increase in contractor personnel responsible for delivery of the required services. Telecare Corporation (Telecare, Contract No, 17-709), and Valley Star Behavioral Health, Inc. (Valley Star, Contract Nos. 17-148 and 17-710) provide CRT program services to approximately 484 individuals annually, at an estimated cost of $21,488 per individual.
Recommendation No. 2
The TAY CRT facility is located in San Bernardino is comprised of 14 beds and provides care for transitional age youth consumers. Services to this specialized population include assessments, treatment plan development, collateral services, crisis intervention, medication support services, and individual and group therapy for individuals diagnosed with mental health and co-occurring disorders.
Due to the new State Community Care Licensing (CCL) requirements effective July 1, 2019, DHCS requires TAY CRT programs to implement Direct Care staffing requirements during 2019-20. The recommended amendment to Contract No. 17-295 with Valley Star will add the additional funds in order to meet CCL requirements and ensure services are delivered per DHCS regulations. Contract No. 17-295 with Valley Star provides TAY CRT program services to approximately 170 individuals annually, at an estimated cost of $15,300 per individual.
PROCUREMENT
On April 4, 2017 (Item No. 11), as the result of a formal procurement, the Board of Supervisors (Board) approved Contract No. 17-148 with Valley Star for CRT program services, in the amount of $25,208,333, for the period of April 4, 2017 through June 30, 2022.
On May 23, 2017 (Item No. 40), as the result of a formal procurement, the Board approved Contract No. 17-295 with Valley Star for TAY CRT program services, in the amount of $12,500,000, for the period of July 1, 2017 through June 30, 2022.
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 amount of $12,083,333, and Contract No. 17-710 with Valley Star for CRT program, in the amount of $12,083,333, both for the period of 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 with Telecare and Contract Nos. 17-148 and 17-710 with Valley Star, updating standard language with no change to the total contract amount or contract period.
The recommended amendments will allow DBH to meet the increased need of consumers requiring CRT and TAY CRT program services in 2019-20. DBH will routinely evaluate DBH consumer utilization of these facilities to address future needs and will present any necessary amendments to the Board for approval. DBH will continue to monitor the contracts on a regular basis to ensure compliance standards are met.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on May 18, 2020; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 19, 2020; Finance (Christopher Lange, Administrative Analyst, 386-8393) on May 26, 2020; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on May 26, 2020.