DATE: June 10, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Participation Agreement No. A-23-629 with
the California Mental Health Service Authority
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment I to Participation Agreement No. A-23-629 with the California Mental Health Service Authority to continue to contract for the provision of state hospital beds and services, extending the term by one year from July 1, 2025, to June 30, 2026, and increasing the maximum by $2,804 to a total of $8,412.
REPORT
There is no additional Net County Cost associated with the recommended action, which will allow the Department to continue its agreement with the California Mental Health Service Authority (CalMHSA) to contract on the County’s behalf for state hospital beds. Continuing this agreement will provide mandated beds and state services for Lanterman-Petris-Short (LPS) conservatees deemed gravely disabled and require this level of care. This item is countywide.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the recommended action is not approved, Fresno County’s contract with CalMHSA will expire and the Department will no longer be authorized to utilize state psychiatric hospital placement and services via the Participation Agreement with CalMHSA.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation for the term would increase by an additional $2,804 in funds for the one-year extension, increasing the total compensation from $5,608 to $8,412. This agreement will be funded with Mental Health Realignment Funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2025-26 Recommended Budget.
DISCUSSION:
Pursuant to California Welfare and Institutions Code (WIC), sections 5000 through 5550, the Lanterman-Petris-Short Act, and WIC section 5600, counties are mandated to provide an array of treatment options for adults with severe mental illness, including 24-hour treatment services at locked inpatient psychiatric hospitals for LPS conservatees who are gravely disabled, as ordered by the court. W&IC, sections 4330-4335 establish the process by which counties contract with DSH for a specified number of hospital beds, services, and the reimbursement method.
On September 14, 2010, the Board approved Agreement No. 10-489 with CalMHSA, authorizing the Department to join the CalMHSA Joint Powers Agreement (JPA), to develop, implement, administer, and provide fiscal oversight of Mental Health Services Act - Prevention and Early Intervention statewide projects. The County has received membership benefits including cost reductions and the related efficiencies of sharing resources and knowledge. On June 18, 2013, the Board approved Amendment I to Agreement No. 10-489, which broadened the scope including the authority to jointly contract with other counties for state hospital beds and services. The amendment was a product of the Department’s JPA membership and delineated that CalMHSA is an administrative agent for the County.
On June 17, 2014, the Board approved Participation Agreement No. 14-327 which allowed CalMHSA to contract with DSH for state hospital bed utilization on behalf of the County and defined the roles and responsibilities between CalMHSA and the County. The Participation Agreement includes an annual payment of $1,402 per bed to CalMHSA to cover administrative charges associated with their procurement of state hospital beds.
On November 28, 2023, the Board approved retroactive Agreement No. 23-169 with CalMHSA to contract on behalf of the County for the provision of state hospital placement and services for adults with severe mental health illness that require a level of care within a locked facility.
Approval of the recommended amendment would modify the program term and the program funding. The term of the agreement would extend the program term end date from June 30, 2025 to June 30, 2026. Program funding would increase by $2,804 for the modified program term, to be invoiced by CalMHSA on July 1, 2025, and due within 30 days of receipt of the invoice. All other terms or provisions in the Agreement shall remain in full force and effect.
REFERENCE MATERIAL:
BAI #49, November 28, 2023
BAI #30, May 11, 2021
BAI #38, June 17, 2014
BAI #57, June 18, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Participation Agreement with CalMHSA
CAO ANALYST:
Ronald Alexander Jr.