Title
Health and Human Services Agency (HHSA) recommending the Board:
1) Make findings that the provision of adult inpatient residential services provided by Contractor are in the public's best interest and that there are specialty skills, qualifications, and equipment not expressly identified in County classifications involved in the performance of the work in accordance with El Dorado County Ordinance Code, Chapter 3.13.030(B);
2) Approve and authorize the Chair to sign Amendment IV to Agreement for Services 3422 with Willow Glen Care Center, increasing the compensation by $1,700,000 for a new not-to-exceed amount of $4,200,000, with no change to the term of the Agreement;
3) Authorize the Purchasing Agent to execute amendments relating to Agreement 3422, contingent upon approval by County Counsel and Risk Management, which do not increase the maximum dollar amount or term of the Agreement; and
4) Authorize the HHSA Director, or Chief Assistant Director, to execute programmatic, administrative, and fiscal documents relating to Agreement 3422.
FUNDING: State Behavioral Health Realignment.
Body
DISCUSSION / BACKGROUND:
The County of El Dorado (County) has an obligation to provide Medi-Cal eligible County residents with access to designated mental health services, including twenty-four (24) hour residential treatment services in accordance with Welfare and Institutions Code (WIC) Section 5600 and pursuant to applicable laws and agreements with the State of California. A licensed residential treatment facility is required to provide these mandated services, which the County does not have at this time.
To meet this requirement, HHSA contracts with Willow Glen Care Center, a residential care facility licensed by the State of California, under Agreement 3422 to provide various levels of care ranging from adults with mental health conditions who need assistance in developing skills to maintain placement in less restrictive levels of care, to mentally ill adults who are unable to maintain traditional residential placement because of persistent behavioral problems. Willow Glen Care Center provides specialized residential care programs for the community’s elderly population ages 60 and over that have a mental illness and need 24/7 residential care. Willow Glen Care Center focuses on providing a continuous diagnostic assessment of an individual’s mental health status, prevention of mental health crisis, stabilization, and maintenance of mental health conditions. These services are necessary to maintain the quality of care and prevent displacement of clients.
Within the County, the 60 and over client population meeting eligibility requirements for placement into Willow Glen Care Center make up the majority of placements for the County’s contracted beds with this facility. As there are no other Community Based Treatment Facilities for the Elderly (RCFE) within a reasonable radius, Willow Glen Care Center is the only facility that HHSA Behavioral Health Division can place these older clients.
Beginning in Fiscal Year (FY) 2022-23, five (5) clients receiving residential treatment aged out of other placement facilities, and Willow Glen Care Center was utilized by HHSA to place these clients. As the County experiences a shortage of placements for adult clients stepping down to a lower level of care, Willow Glen Care Center was the only contracted facility available for placement.
Consequently, HHSA had to reallocate $200,000 in funding from FY 2023-24 to FY 2022-23 to cover the increased placement cost. As these clients continue to reside at Willow Glen Care Center, the funding increase is needed to cover these additional client placements throughout the remainder of the term through December 31, 2024. This Amendment IV to Agreement 3422 will add $1,700,000 in funding for a new total not-to-exceed amount of $4,200,000.
Willow Glen Care Center fills a large gap in HHSA’s Behavioral Health system of care, as it is the only contractor providing the necessary level of care to house elderly clients. If HHSA is unable to increase the contract amount of Agreement 3422, this will leave a large gap in residential placement services and may result in existing clients to lose their housing.
HHSA recommends the Board approve of this Amendment IV to Agreement 3422 to allow the continuation of mandated placement for adult residential treatment in El Dorado County.
ALTERNATIVES: Should the Board decline to approve this recommendation, HHSA would continue to provide residential services through existing contracts as capacity allows, however, may experience deficiencies in placing clients over the age of 59 and may be unable to meet the demand for mandated placements for County residents.
PRIOR BOARD ACTION:
12/4/2018, 18-1549, HHSA #3422 Willow Glen Care Center
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel, Human Resources, Risk Management, and Procurement and Contracts. The Auditor was notified in adherence 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 2023-24 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 Amendment IV of Agreement #3422
STRATEGIC PLAN COMPONENT:
Healthy Communities
CONTACT
Olivia Byron-Cooper, MPH, Interim Director, Health and Human Services Agency