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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, Contracting Out, that the Skilled Nursing Facility services provided by Helios Healthcare, LLC (Helios) requires specialty skills and qualifications not expressly identified in County classifications are involved in the performance of the work;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(2f) 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 Amendment I to Agreement for Services 8860 with Helios to allow more than one client to utilize this Agreement, update various contract provisions, and extend the term for two additional years, for an overall three year term expiring June 20, 2027, increasing the contract value by $324,198, for a new amount of $400,000;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 8860, 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 8860.
FUNDING: 100% Behavioral Health Realignment.
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DISCUSSION / BACKGROUND:
On behalf of the County, HHSA contracts with the State as the Medi-Cal Mental Health Plan (MHP). As the MHP, HHSA is required to provide Specialty Mental Health Services (SMHS) to Medi-Cal beneficiaries residing in El Dorado County who meet medical necessity criteria in accordance with Section 14184.402 of the California Welfare and Institutions Code (WIC). These services include Psychiatric Nursing Services, defined under Title 9 Section 1810.239 of the California Code of Regulations (CCR) as Skilled Nursing Facility (SNF) services that involve special treatment programs for individuals with mental disorders. These services must be provided by a SNF licensed and certified by the California Department of Public Health (CDPH).
Helios operates Idylwood Care Center (Idylwood), a 170-bed SNF located in Santa Clara County, offering both secured and unsecured environments depending on the individual's needs. Idylwood is licensed and certified by CDPH to provide SNF services to adults with Serious Mental Illness (SMI). Idylwood provides specialized skilled nursing services, including but not limited to, IV therapy, parenteral nutrition, wound care, pain management, physical therapy, and comprehensive mental health services. Individuals placed at Idylwood continue the therapeutic treatment started in the hospital, with the goal of transitioning to an appropriate community placement.
On June 21, 2024, Agreement 8860 with Helios was approved by the Purchasing Agent, with a maximum obligation of $75,802 and a term ending on June 20, 2025. Amendment I to Agreement 8860 expands the scope of services, updates contract provisions, extends the term, and increases the maximum obligation.
The proposed amendment ensures continuity of care for the current client at this facility and allows other qualified individuals, aged 18 and older, referred by the County’s Behavioral Health Division and Office of Public Guardian, who meet the criteria for SMHS, to be placed at Helios for SNF services on an as-needed basis.
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 which states "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." As these services are currently being provided by Helios under Agreement 8860, a HHSA client is currently engaged in services.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the El Dorado County resident currently placed at Helios would need to be transferred to a different facility. However, the County faces a significant risk of being unable to secure an appropriate placement. This could disrupt the continuity of care for the client, and the County may also risk non-compliance with State regulations. Without this contract, the County’s ability to access qualified SNFs for adult clients with SMI will remain severely limited, ultimately impacting the capacity to meet the service requirements of the MHP.
PRIOR BOARD ACTION:
N/A
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by 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. Sufficient appropriations were included in the Fiscal Year 2024-25 Budget, the 2025-26 Budget request, 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 Amendment I to Agreement for Services 8860.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency