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Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings pursuant to El Dorado County Ordinance Chapter 3.13, Contracting Out, that the Acute Psychiatric Inpatient Hospital Services provided by BHC Heritage Oaks Hospital, Inc. doing business as Heritage Oaks Hospital (Heritage Oaks) and BHC Sierra Vista Hospital, Inc. doing business as Sierra Vista Hospital (Sierra Vista) requires specialty skills and qualifications not expressly identified in County classifications;
2) Make findings in accordance with Procurement Policy C-17 Section 3.4(2f) exempting the competitive bidding process, with Purchasing Agent (PA) concurrence, for perpetual Agreements 846 and 847, 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 846 with Heritage Oaks, to update various contract provisions and increase the maximum obligation by $300,000 per fiscal year for a new amount of $500,000 per fiscal year, with no change to the perpetual term;
4) Approve and authorize the Chair to sign Amendment II to Agreement for Services 847 with Sierra Vista, to update various contract provisions and increase the maximum obligation by $200,000 per fiscal year for a new amount of $500,000 per fiscal year, with no change to the perpetual term;
5) Authorize the PA to execute amendments relating to Agreements 846 and 847, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum obligation per fiscal year in the perpetual agreements; and
6) Authorize the HHSA Director, or the Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreements 846 and 847.
FUNDING: 100% Behavioral Health Realignment.
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DISCUSSION / BACKGROUND:
HHSA contracts with the State of California to serve as the Medi-Cal Mental Health Plan (MHP) in El Dorado County. As the MHP, HHSA contracts with various acute psychiatric inpatient hospital facilities to ensure availability of services on an “as needed” basis, pursuant the County’s executed MHP Agreement and in compliance with 42 California Code of Federal Regulations Section 438.2.
Under the MHP Agreement, HHSA is obligated to provide inpatient psychiatric hospital services to eligible clients, including Medi-Cal beneficiaries and medically indigent individuals residing in El Dorado County.
On June 10, 2014, the Board approved perpetual Agreements 846 and 847 for the provision of acute inpatient mental health services. Heritage Oaks and Sierra Vista provide these services, which include routine hospital and hospital-based ancillary services necessary for the diagnosis or treatment of mental disorders, as defined under Title 9, California Code of Regulations Sections 1810.201, 1810.238, 1810.350, and 1810.430(d)(5) (Legistar file 14-0698).
On February 5, 2019, the Board approved Amendment I to Agreement 847 with Sierra Vista, which increased the maximum obligation per fiscal year by $100,000, for the revised total obligation of $300,000 per fiscal year (Legistar file 18-1904).
Due to increasing utilization and projected service demands, the current maximum obligations per fiscal year under the existing agreements are no longer sufficient to meet the County’s needs. As a result, Amendment I to Agreement 846 with Heritage Oaks increases the not-to-exceed amount from $200,000 to $500,000 per fiscal year, while Amendment II to Agreement 847 with Sierra Vista increases the not-to-exceed amount from $300,000 to $500,000 per fiscal year. The amendments also update articles to current standard agreement language. These amendments are necessary to ensure the County can continue providing timely and adequate access to inpatient psychiatric care for eligible residents.
In accordance with the Board Procurement Policy C-17, the contractors are exempt from competitive bidding, with PA concurrence, per Section 3.4 (2)(f), 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. HHSA has been contracting with both Heritage Oaks and Sierra Vista through these perpetual agreements since 2014 to provide as-needed acute inpatient psychiatric care to Medi-Cal beneficiaries residing in El Dorado County.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide services through existing contracts with other vendors, which would limit HHSA’s capacity for these services.
PRIOR BOARD ACTION:
1) 06/10/14, 14-0698, HHSA BHC Heritage Oaks, BHC Sierra Vista, and BHC West Hills
2) 02/05/19, 18-1904, HHSA BHC Sierra Vista Hospital, 847 A1
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, and Risk Management. The Auditor-Controller was notified in accordance with 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 2025-26 Budget, and will be included in future budgets for the terms of the Agreements to cover projected as-needed services.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
1) Clerk of the Board to obtain signature of Chair on one original Amendment I to Agreement for Services 846; and
2) Clerk of the Board to obtain signature of Chair on one original Amendment II to Agreement for Services 847.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency