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Health and Human Services Agency (HHSA) recommending the Board:
1) Approve and authorize the Chair to sign Amendment I to Revenue Agreement RFS-988 (5818) with County of Nevada, for this county’s use of the El Dorado County Psychiatric Health Facility (PHF) for placement of their mental health clients, increasing revenue by $200,000 and amending the maximum obligation language to replace annual appropriations with a new not-to-exceed amount of $800,000, with no change to the term of the Agreement;
2) Authorize the Purchasing Agent to execute amendments relating to Agreement 5818, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
3) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 5818.
FUNDING: Fee-for-Service revenue received from County of Nevada.
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DISCUSSION / BACKGROUND:
The El Dorado County (County) PHF is a secure 16-bed facility that provides intensive mental health and psychiatric treatment services to admitted clients in a safe and welcoming environment. Clients admitted to the County’s PHF are adults, ages 18 and over, that are experiencing a mental health emergency. Prior to admission, individuals will have a medical screening performed to determine if they are medically stable to be admitted, in adherence with California Welfare and Institutions Code Section 5150.
HHSA has contracted with other counties for many years to provide access to the County's PHF, and for the provision of mental health services for their clients who require acute inpatient mental health services and are eligible for these services. Services provided by the County PHF include psychiatry, medication, clinical treatment, nursing, and the required documentation and maintenance of health information in accordance with prevailing federal and state laws and regulations. Accepting clients from other counties helps HHSA to maximize revenues and offset fixed operational costs of the PHF, while assisting other counties with their mandated mental health services.
On May 4, 2021, Revenue Agreement RFS-988 (5818) with County of Nevada was approved by the Board to allow the County of Nevada to refer clients for admission to the County's PHF, based on bed availability, with one dedicated bed reserved for County of Nevada clients, for the term effective July 1, 2021 through June 30, 2024, with a Fiscal Year (FY) not-to-exceed amount of $200,000, and a maximum obligation of $600,000 (File ID: 21-0259). Under this Agreement, the County of Nevada reimburses HHSA for their admitted clients’ usage of PHF beds.
Amendment I to this Revenue Agreement amends the compensation by adding $200,000, for a new maximum obligation of $800,000, and changes the maximum obligation from a FY not-to-exceed amount to an overall not-to-exceed agreement amount and updates standard contract articles. This First Amendment was requested by the County of Nevada to allow for greater flexibility in compensation, as their use of the PHF fluctuates annually based on client needs and was requested to not be restricted to a fiscal year not-to-exceed compensation structure. The funding increase is based on the County of Nevada’s historical bed-use fluctuations and takes into consideration the anticipated use of the County PHF for the remainder of the Agreement’s term.
HHSA recommends the Board approve this Amendment I to allow HHSA to continue maximizing revenues and offset fixed operational costs of the PHF with the increased maximum obligation, while assisting the County of Nevada with their mandated mental health services.
ALTERNATIVES:
Should the Board decline to approve this recommendation, the County will continue to provide PHF services, but the County will not be able to maximize PHF revenue by providing services to Nevada to include the reservation of one dedicated bed.
PRIOR BOARD ACTION:
1) 17-1268, 04/24/18, HHSA Nevada County (Use of PHF) 295-S1811
2) 19-1397, 12/17/19, HHSA PHF Telecare Agreements 4330 and 4332
3) 21-0259, 05/04/21, HHSA County of Nevada Use of PHF RFS-988
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
Approved by County Counsel and Risk Management.
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no Net County Cost associated with the revenue generating Agreement. Revenue from this Agreement is included in the HHSA Behavioral Health Division budget for Fiscal Year 2023-24.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain signature of Chair on two (2) original Amendment I for Agreements for Services RFS-988 (5818); and
2) Clerk of the Board to return one (1) fully executed Agreement to HHSA Contracts Unit at 3057 Briw Rd, Suite B.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency