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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 A&A Health Services, LLC, doing business as A&A Health Services, San Pablo (AAHS San Pablo) 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 9629 with AAHS San Pablo, in the amount of $3,300,000, and for the term of three years from September 1, 2025, through August 31, 2028;
4) Authorize the Purchasing Agent to execute amendments relating to Agreement 9629, 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 9629.
FUNDING: 100% State 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, operating under state and federal regulations, including California Welfare and Institutions Code (WIC) Sections 5600 et seq., 14000 et seq., and 17000 et seq. As the MHP, HHSA is responsible for providing Specialty Mental Health Services (SMHS) to eligible individuals. To fulfill this responsibility and ensure service availability on an as-requested basis, HHSA enters into multiple contracts with long-term residential treatment facilities, in compliance with Title 9 and Title 22 of the California Code of Regulations and WIC Division 5. HHSA’S Behavioral Health Division (BHD), as part of this responsibility, offers a range of mental health services focused on coordinated, integrated care systems and residential treatment alternatives, including securing long-term ARF placements when clinically appropriate.
ARFs support clients transitioning from secure settings, such as acute care, forensic environments, or Institutes for Mental Disease, to less restrictive community living. AAHS San Pablo, a licensed 225-bed ARF in Contra Costa County, has contracted with the County since 2022 to provide mental health supportive services. It offers a homelike environment focused on structure, skill-building, stabilization, recovery, healthy meals, recreation, and transportation. AAHS San Pablo primarily serves individuals with histories of homelessness, institutionalization, or incarceration, including a diverse justice-involved population ranging from high-acuity clients eligible for diversion to lower-level offenders.
HHSA’s BHD and Public Guardian clients, between ages of eighteen and sixty-four years old, who meet SMHS criteria under WIC Section 14184.402, may be referred to AAHS San Pablo for the ARF services outlined in proposed Agreement 9629. This proposed Agreement with AAHS San Pablo is a renewal of Agreement 6416, which was approved by the Board on August 30, 2022, to ensure the uninterrupted continuation of essential ARF services (Legistar file 22-0365).
In accordance with the Board 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. Because the need for these services in El Dorado County far outweighs the availability of beds, HHSA contracts with as many qualified vendors as possible, within a reasonable proximity, to provide ARF services to Medi-Cal beneficiaries residing in El Dorado County. HHSA seeks to maintain existing residential contracts in place to ensure client/clinician continuity of care.
ALTERNATIVES:
Should the Board decline to approve this recommendation, HHSA would continue to provide services through existing contracts; however, HHSA clients may experience extended wait times for an available ARF bed, particularly because AAHS San Pablo is one of the County's few contracted providers specializing in services for individuals transitioning from penal institutions. Additionally, the continuity of care for El Dorado County client(s) currently placed at AAHS San Pablo would be significantly disrupted.
PRIOR BOARD ACTION:
08/30/22, 22-0365, HHSA, A&A Health Services, 6416
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
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. Sufficient appropriations were included in the Fiscal Year 2025-26 Budget and will be included in future budgets for the terms of the Agreement.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on one original Agreement for Services 9629.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency