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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 the Adult Residential Facility services provided by Compassion Pathway Behavioral Health LLC (Compassion Pathway) 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 Agreement for Services 9284 with Compassion Pathway, in the amount of $2,932,000 for the initial term of three years, from March 25, 2025, through March 24, 2028, with the option to extend the term for one additional year through March 24, 2029, for a total maximum compensation amount of $3,910,000, if the extension is granted;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 9284, 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 9284.
FUNDING: 94% Mental Health Services Act, 6% State Behavioral Health Bridge Housing.
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DISCUSSION / BACKGROUND:
HHSA’s Behavioral Health Division (BHD), serving as the El Dorado County Mental Health Plan (MHP), operates under state and federal regulations, including California Welfare and Institutions Code (WIC) Sections 5600 et seq., 14000 et seq., and 17000 et seq. As part of its responsibilities, BHD is required to provide a range of mental health services to eligible county residents, focusing on coordinated and integrated care systems, as well as residential treatment alternatives. This includes securing Adult Residential Facility (ARF) placements when clinically appropriate and developing residential treatment programs in compliance with WIC Section 5670, which mandates alternatives to institutional care.
Currently, BHD does not have a contracted ARF within the County. The Fiscal Year (FY) 2024-2025 MHSA Annual Update includes a provision for the operation of an ARF within the County (Legistar file 24-0832). The purpose of this provision is to enhance the County's adult mental health system of care by providing supportive living environments for adults with Serious Mental Illness. ARFs are a crucial step in the transition of BHD clients coming out of acute inpatient settings towards more independent living.
The proposed Agreement 9284 with Compassion Pathway, which operates the state-licensed Carlson Springs ARF, will provide ten dedicated beds for County clients. This contract will allow BHD and the Public Guardian Office to deliver long-term residential services for individuals between the ages of 18 and 59 who meet the criteria for Specialty Mental Health Services (SMHS), on an “as requested” basis, in accordance with WIC Section 14184.402. Clients aged 60 and older may be admitted, provided they are ambulatory, can perform Activities of Daily Living, and meet other admission criteria specified in California Code of Regulations Title 22 Section 85068.4. In addition to 24-hour supervision, the ARF's Enhanced Services are designed to assist clients in the development of skills to become more self-sufficient and to move towards increasing levels of independent functioning. The Carlson Springs ARF will address a critical gap in the County's adult mental health services, ensuring adherence to these statutory requirements.
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. Given the high demand for these services in the County and the limited availability of beds, HHSA contracts with as many qualified vendors as possible to meet the ongoing needs of the County’s Medi-Cal beneficiaries. This agreement will allow up to ten BHD clients currently placed in out-of-county facilities to return to the County or to step down from higher levels of care.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide ARF services through existing contracts but will not have a contracted ARF within County lines. As a result, clients currently placed in an out-of-County residential facility will be unable to return home, and future BHD clients in need of ARF services will continue to be placed out of County. Additionally, without this contract, the County will continue to have diminished capacity to step eligible clients down from higher, more expensive levels of care.
PRIOR BOARD ACTION:
06/18/24, 24-0832, HHSA MHSA FY 2024-25 Annual Update
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 as funding is provided through state-funded MHSA and Behavioral Health Bridge Housing. 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, as well as Medi-Cal reimbursement as appropriate.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on one original Agreement for Services 9284
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency