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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 crisis residential treatment services provided by Compassion Pathways Behavioral Health LLC (Compassion Pathways);
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 Agreement for Services 8976 with Compassion Pathways, with a not to exceed amount of $2,950,000 for the initial term of execution through June 30, 2026, with the option to extend the term for one additional year through June 30, 2027, and a total maximum obligation of $4,350,000;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 8976, 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 8976.
FUNDING: 50% Federal Medi-Cal, 3% American Rescue Plan Act (ARPA), 47% State Mental Health Services Act (MHSA).
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DISCUSSION / BACKGROUND:
As the Mental Health Program (MHP) of El Dorado County, HHSA Behavioral Health Division (BHD) is required to provide specialty mental health services (SMHS) in accordance with County Ordinance 3.13.030 and the California Welfare and Institutions Code Division 5, Part 2, Chapter 1 The Bronzan-McCorquodale Act 5600.3(b). To meet this requirement, BHD contracts with providers of Crisis Residential Treatment facilities to ensure availability of services for County residents experiencing an acute psychiatric episode or crisis who do not have medical complications requiring nursing care.
HHSA recommends contracting with Compassion Pathways for use of this contractor’s Oak Lane Crisis Residential Treatment (CRT) facility with ten dedicated beds to serve County clients as an alternative to psychiatric hospitalization, Psychiatric Hospital Facility (PHF) step downs, and El Dorado County Jail transition referrals. On December 11, 2012, the Board approved the elimination of the MHSA Community Services and Supports Work Plan No. 3 "Crisis Residential Treatment Facility" moving the six beds that were dedicated to the CRT back to the County Psychiatric Health Facility (PHF) (File ID 12-1455).
On June 20, 2023, the Board adopted El Dorado County's MHSA Three-Year Program and Expenditure Plan covering Fiscal Year (FY) 2023-24 through FY 2025-26, which outlines the Community Services and Supports (CSS) components of MHSA including the CRT Project which specified that HHSA will “build, buy or lease a building for a CRT facility in El Dorado County” and estimated that 70 individuals would be served at this facility (File ID 23-0933).
The Oak Lane CRT will be the first CRT that Compassion Pathways will be operating in El Dorado County. Compassion Pathways has contracted with El Dorado County since 2022 for Social Rehabilitation Facility services in El Dorado County and is the developing a contract for Adult Residential Facility services in El Dorado County. Compassion Pathways also operates Bella Vida Center, a CRT in Chico, and several other Behavioral Health treatment facility types across northern California.
Maintaining a CRT facility in El Dorado County will strengthen the Behavioral Health system of care by providing voluntary CRT placements within our community for those exiting the Psychiatric Health Facility (PHF) who are eligible for a lower level of care and preventing PHF placements by assisting clients at a lower level of care who are likely to decompensate without sustained crisis intervention.
Through proposed Agreement 8976, Compassions Pathways, through its Oak Lane CRT facility, will provide therapeutic or rehabilitative services 24 hours a day, 7 days a week, in a non-institutional residential setting with a structured program as an alternative to hospitalization for adults countywide experiencing an acute psychiatric episode or crisis who do not have medical complications requiring nursing care.
In accordance with Board of Supervisors Procurement Policy C-17, the contractor is 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”. Oak Lane Crisis Residential Facility, operated by Compassion Pathways is the only vendor within El Dorado County currently providing CRT services with 10 available dedicated beds and has critical knowledge about the service being provided and the population being served.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA BHD would continue to provide residential services using the County’s PHF, however would be unable to provide CRT services. This would result in client placement into a higher level of care, up to and including a Mental Health Rehabilitation Center/Institution for Mental Disease.
PRIOR BOARD ACTION:
12/11/12, 12-1455, HHSA CRT-PHF Presentation
06/20/23, 23-0933, HHSA Adoption of FY 2023-24 - FY 2025-26 MHSA 3- Year Program and Expenditure Plan.
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel, Human Resources, and Risk Management. Auditor Controller was notified in accordance with Policy B-12.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund Cost associated with this agenda item. Sufficient appropriations were included in the Fiscal Year 2024-25 Budget and will be included in future budgets for the term of the Agreement. There is a portion of the agreement funded by ARPA funding allocated to HHSA by the Board for this purpose.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on one original Agreement for Services 8976
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency