REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 14, 2022
FROM
GEORGINA YOSHIOKA, Interim Director, Department of Behavioral Health
SUBJECT
Title
Contract with Loma Linda University Behavioral Medicine Center for Electroconvulsive Treatment Services
End
RECOMMENDATION(S)
Recommendation
Approve contract with Loma Linda University Behavioral Medicine Center for the provision of electroconvulsive treatment services, in an amount not to exceed $1,237,500, for the period of July 1, 2022 through June 30, 2027.
(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 total amount of $1,237,500 ($247,500 annually) for the provision of electroconvulsive treatment (ECT) services is funded by the Mental Health Services Act and 1991 Realignment. Adequate appropriation and revenue will be included in the Department of Behavioral Health’s (DBH) 2022-23 recommended budget and in future recommended budgets.
BACKGROUND INFORMATION
DBH is responsible for providing mental health, alcohol, and substance use disorder services to San Bernardino County residents who are experiencing major mental illness, substance use disorder, and other addictions. An integral part of the service delivery system consists of County operated and contracted service providers delivering a variety of mental health treatment services.
The recommended contract with Loma Linda University Behavioral Medicine Center (LLUBMC) will provide ECT services to patients authorized by DBH, including physician services staff, anesthesiologists, recovery nurses, and outpatient treatment facility staff. On August 22, 2017 (Item No. 17), the Board of Supervisors approved the contract for ECT services with LLUBMC, in an amount not to exceed $990,000, for the period of August 22, 2017 through June 30, 2022. ECT is a safe, efficient, and effective biological treatment for clients with certain severe mental disorders such as depression, schizophrenia, schizoaffective disorder, bipolar disorder, mania, catatonia, and/or persistent suicidal ideation, that have not responded to reasonable pharmacological treatment. LLUBMC’s ECT services are a comprehensive, all-inclusive and specialized treatment, which includes physician, anesthesiologist, recovery nurse, and hospital facility services. DBH anticipates that LLUBMC will provide up to 165 treatment sessions annually in both inpatient and outpatient settings, at a cost of $1,500 per session with an average of 20 sessions per client at an average cost of $30,000.
DBH clients with Medi-Cal insurance are eligible to receive ECT services only in an inpatient setting. Under the terms of the agreement with LLUBMC, ECT services will be provided in both inpatient and outpatient settings, in an effort to reduce inpatient hospitalizations. Medi-Cal clients requiring ECT services in an outpatient setting are an unserved population within the County, creating a gap in required treatment/services for this population. The recommended agreement with LLUBMC for ECT services will provide outpatient Medi-Cal clients an opportunity to decrease psychiatric hospitalizations, reduce suicidality, and improve functional abilities; thereby improving their quality of life.
PROCUREMENT
DBH is recommending a non-competitive contract with LLUBMC for ECT services as LLUBMC is the only known provider in the county that has demonstrated experience and specialty in ECT treatment. Purchasing supports the non-competitive contract with LLUBMC for ECT services with a justification of specialized credentials.
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contracts Supervisor, 388-0858) on May 17, 2022; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on May 24, 2022; Purchasing (Bruce Cole, Supervising Buyer, 387-2148) on April 26, 2022; Finance (Christopher Lange, Administrative Analyst, 386-8393) on May 23, 2022; and County Finance and Administration (Cheryl Adams, Deputy Executive Officer, 388-0238) on May 31, 2022.