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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to Section 3.13.030 (B) of the El Dorado County Ordinance Chapter 3.13, Contracting Out, that specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work of Agreement for Services 8944 with California Psychiatric Transitions Incorporated;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(2.f) exempting the competitive bidding process, with Purchasing Agent concurrence, because “the procurement is for services where the continuity of providers will provide efficiency or critical knowledge, and other providers of the services cannot provide similar efficiencies or critical knowledge;
3) Approve and authorize the Chair to sign Agreement for Services 8944 with California Psychiatric Transitions Incorporated in the amount of $2,200,000 and effective upon final execution for the term of three years with the option to extend the term for one additional year for a total term not to exceed four years;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 8944, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
5) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 8944.
FUNDING: 100% State of California Behavioral Health Realignment Funding.
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DISCUSSION / BACKGROUND:
HHSA’s Behavioral Health Division (BHD) serves as the El Dorado County Mental Health Plan (MHP) and operates under rules set forth by the state and the federal government. As the MHP, HHSA BHD is required to provide Specialty Mental Health Services (SMHS) to eligible individuals, including long-term residential facility placements when appropriate. To meet this requirement, HHSA contracts with multiple providers of inpatient residential treatment facilities to ensure availability of services on an "as requested" basis in accordance with Title 9 and Title 22 of the California Code of Regulations (CCR) and Division 5, Chapter 5 of the California Welfare and Institutions Code (WIC).
Psychiatric Transitions Incorporated (CPT) operates a 98-bed Mental Health Rehabilitation Center (MHRC) in Merced County that is licensed by the Department of Health Care Services (DHCS). Since 2008, CPT has been providing long-term residential psychiatric treatment and 24/7 care to County adult clients with serious mental illness. CPT offers treatment services tailored to various acuity levels and serves as an alternative to state hospital placements for eligible individuals according to DHCS criteria. CPT’s MHRC facility is designed to meet the needs of individuals under court-ordered diversion programs or facing charges for felonies/misdemeanors but deemed incompetent to stand trial under the California Penal Code. HHSA’s BHD and Public Guardian clients, who meet the criteria for SMHS outlined in WIC Section 14184.402 and are aged between 18 and 63 years, may be referred to CPT to access residential treatment services as detailed in Agreement 8944.
Through proposed Agreement 8944, CPT will continue to provide the same services described in Agreement 5298, approved by the Board on March 16, 2021, for the term of April 1, 2021 through March 31, 2024 and Amendment I approved by the Board on March 19, 2024, for a six month term extension expiring September 30, 2024 (Legistar file 20-1644 and 24-0474). HHSA recommends the Board approve of this new Agreement with CPT to ensure this contractor can continue the provision of MHRC services to County residents.
In accordance with Board of Supervisors Procurement Policy C-17, HHSA recommends this agreement be exempt from competitive bidding, with Purchasing Agent concurrence, per Section 3.4(2f) as "the procurement is for services where the continuity of providers will provide efficiency or critical knowledge, and other providers of the services cannot provide similar efficiencies or critical knowledge." Because the need for these services in El Dorado County far outweighs the availability of beds, HHSA contracts with as many qualified vendors as possible to provide psychiatric care to Medi-Cal beneficiaries residing in El Dorado County. HHSA seeks to maintain existing residential contracts in place to ensure client/clinician continuity of care.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA will be unable to comply with court orders related to diversion programs and would have diminished capacity to provide services required of the MHP and meet service demands of the community.
PRIOR BOARD ACTION:
1) 03/16/21, 20-1644, HHSA CA Psych Transitions 5298
2) 03/19/24, 24-0474, HHSA C#5298 A1
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, and Risk Management. The Auditor Controller has been notified per Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with this agenda item as funding is provided through state funded Behavioral Health Realignment. Sufficient appropriations have been included in HHSA’s Fiscal Year 2024-25 Budget and will be included in future budgets for the term of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one original Agreement for Services 8944.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency