REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 8, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Contract with Stoney Point Healthcare Center for Skilled Nursing Facility Services
End
RECOMMENDATION(S)
Recommendation
Approve contract with Stoney Point Healthcare Center to provide Skilled Nursing Facility psychiatric and medical care services, in an amount not to exceed $2,463,750, for the contract period of February 8, 2022 through December 31, 2026.
(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). The cost of the contract with Stoney Point Healthcare Center (Stoney Point) will not exceed $2,463,750 and is funded by 1991 Realignment. Adequate appropriation and revenue have been included in the Department of Behavioral Health’s (DBH) 2021-22 budget and will be included in future recommended budgets.
BACKGROUND INFORMATION
Approval of the recommended contract with Stoney Point will provide access to a total of 10 beds for DBH consumers in need of a Skilled Nursing Facility (SNF) level of care, as a step down from more acute and costly locked facilities, including State Hospitals. The SNF provides a variety of specialized behavioral interventions for severely persistently mentally ill (SPMI) consumers who require psychiatric monitoring in addition to treatment for their comorbid medical condition. DBH continuously seeks local SNFs, or those in close proximity, willing to provide skilled nursing services, however, due to the severity of mental and/or medical conditions experienced by DBH’s hardest to serve consumers, other types of facilities are not willing to accept them. Stoney Point is available to meet the needs of the County’s SPMI target population. DBH anticipates Stoney Point will provide approximately 3,650 annual bed days, at a cost not to exceed $135 per bed, per day.
DBH is responsible for providing mental health and/or substance use disorder services to San Bernardino County residents who are experiencing major mental health issues and/or a substance use disorder. An integral part of the service delivery system consists of providing specialized treatment services to the seriously mentally ill population. The highest level of care is the State Hospital psychiatric unit; the second highest level of treatment is provided through Institutions for Mental Diseases and SNFs. DBH appropriately places consumers in SNFs as they offer an appropriate higher, less costly level of care. San Bernardino County consumers in need of specialized services of a SNF are placed consistent with care guidelines of that facility. DBH provides medically necessary, third-party non-emergency medical transportation for the consumer to the SNF. Upon arrival/admission, consumers’ care and any future transport needs are covered by the SNF facility. SNFs are licensed by the State of California, Department of Health Care Services.
Stoney Point requests mutual indemnification in the contract, which is a non-standard term and condition that differs from the standard County contract. The County standard contract language requires the contractor to indemnify the County in accordance with County Policy 11-07.
• The contract with Stoney Point allows for mutual indemnification.
• Potential Impact: The County standard contract does not include any indemnification or defense by the County of a Contractor, and here the County must also indemnify Stoney Point for those same types of claims. The County could be liable for potential harm or loss incurred by Stoney Point.
PROCUREMENT
DBH routinely performs searches for SNFs licensed throughout Southern California that will accept consumers with psychiatric needs and severe medical issues, including dementia-related disorders. Stoney Point is recommended to provide the required SNF services as they specialize in providing services to SPMI consumers with psychiatric and medical-related conditions whom other facilities will not accept. Purchasing supports the non-competitive contract with a specialized credentials justification.
The recommended contract with Stoney Point will ensure the County continues to provide services to DBH consumers requiring specialized SNF care. DBH will monitor contract performance on a regular basis to ensure performance and compliance standards are met by reviewing monthly reports, ongoing site visits to review consumer progress, as well as an annual program review. The provider invoices will be reviewed and approved by DBH Programs to ensure clients and bed count are accurate prior to being forwarded to Fiscal for payment. Fiscal will verify signatures, bed rate and total cost prior to issuing payment.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on December 28, 2021; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on January 4, 2022; Purchasing (Bruce Cole, Supervising Buyer, 387-2148) on January 3, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393) on January 20, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on January 20, 2022.