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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 outlined in Agreement for Services 8631 with Crestwood Behavioral Health, Inc. to provide long-term residential intensive inpatient psychiatric and rehabilitation services;
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 goods cannot provide similar efficiencies or critical knowledge”;
3) Approve and authorize the Chair to sign Agreement for Services 8631 with Crestwood Behavioral Health, Inc. in the amount of $5,400,000 and for the term of three years from July 1, 2024, through June 30, 2027;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 8631, 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 8631.
FUNDING: 100% Behavioral Health Realignment State 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 of California (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, the MHP contracts with 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 Welfare and Institutions Code (WIC).
Crestwood Behavioral Health, Inc., (Crestwood) is licensed by the State to provide long-term residential intensive inpatient psychiatric and rehabilitation services to adults with serious mental health disorders and operates more than 30 facilities throughout the State. Crestwood’s services are designed to assist eligible clients, ages 18 or older, in the development of skills to become more self-sufficient and to move toward increasing levels of independent functioning with the goal of community reintegration. HHSA’s BHD and Public Guardian clients, who meet criteria for SMHS as established by WIC Section 14184.402 are referred to Crestwood to receive the residential services outlined in proposed Agreement 8631.
HHSA has contracted with Crestwood since 2007. This proposed Agreement with Crestwood is a renewal of Agreement 5363 approved by the Board on April 13, 2021 (Legistar file 21-0207). The proposed renewal Agreement will ensure continuation of necessary Adult Inpatient/Residential Treatment Services without any service interruption.
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." As these services are currently being provided by Crestwood under Agreement 5363, HHSA clients are currently engaged in services with licensed clinicians/facilities. Any disruption of a client’s continuity of care with an established client/clinician partnership through their placement in one of Crestwood’s residential facilities could have a detrimental impact on client care and recovery. To avoid client service interruption, HHSA recommends the Board find the competitive bidding exemption necessary to ensure service continuity.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide inpatient residential treatment services through existing contracts but would be limited in its access to these types of facilities. Subsequently, the County would have diminished capacity to provide services required of the MHP, and the continuity of care for clients currently placed in one of Crestwood facilities would be disrupted.
PRIOR BOARD ACTION:
1) 05/17/2016, 16-0391, v.1, HHSA Crestwood
2) 05/23/2017, 16-0391, v.2, HHSA Crestwood Amend
3) 06/04/2019, 19-0004, HHSA AMDT 3, #25 (010-S1711) Crestwood Behavioral Health, Inc.
4) 04/13/2021, 21-0207, HHSA Crestwood Behavioral Health 5363
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Risk Management, and Human Resources. 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 (1) original Agreement for Services 8631.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency