DATE: May 26, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Master Agreement with Licensed Residential Facilities for Adult Transitional Social Rehabilitation Program Services
RECOMMENDED ACTION(S):
TITLE
1. Make a finding that it is in the best interest of the County to waive the competitive bidding process consistent with Administrative Policy No. 34 under the “unusual or extraordinary circumstances” provision for the delivery of services with licensed residential facilities for Adult Transitional Social Rehabilitation Program for persistent and severely mentally ill adult individuals.
2. Approve and authorize the Chairman to execute a Master Agreement with licensed residential facilities for Adult Transitional Social Rehabilitation Program services for persistent and severely mentally ill adult individuals, effective July 1, 2020, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $11,844,000.
3. Authorize the Department of Behavioral Health Director or designee to add and/or delete facilities for Transitional Social Rehabilitation Program services.
REPORT
Approval of the recommended actions will allow the Department of Behavioral Health to continue to provide a less restrictive level of care to persistent and severely mentally ill adult clients through the utilization of licensed facilities that are certified to provide residential Transitional Social Rehabilitation Program (TSRP) services. The facilities provide services that are designed to minimize the risk of client hospitalizations and assist clients with the development of independent living skills with the goal of movement toward a less structured setting. Approval of the third recommended action will allow the Director of the Department to add or delete licensed TSRP Facilities to the recommended Master Agreement with no net County cost.
ALTERNATIVE ACTION(s):
Should the recommended actions not be approved, the Department would be unable to place clients at licensed facilities certified to provide transitional social rehabilitation services, requiring the department to place persistent and severely mentally ill adult clients in a higher level of care through Master Agreement No. 16-294 which consists of Skilled Nursing Facilities (SNF), Geropsychiatric Nursing Care Facilities (GNCF), Institutions of Mental Disease (IMD), and Mental Health Rehabilitation Centers (MHRC); all of which are secured facilities. The other alternative would be placement in an even lower level of care facility such as Transitional Residential Services Program facilities; however, clients may not be ready for such a reduction in care and/or transitional residential care facilities may not have the capacity or licensing exemptions to accept clients requiring a higher level of care.
SUSPENSION OF COMPETITION CONTRACT:
The Department requests the Board to waive the competitive bidding process consistent with Administrative Policy Number 34 due to the non-competitive nature of the Master Agreement. All qualified, licensed and interested vendors will be added to the Master Agreement to meet the department’s placement needs as assessed by clinical staff and in accordance with all terms and conditions specified in the contract (including all credentialing and compliance requirements) will be able to participate as a contracted provider. If approved, the Department’s Director, or designee, will be able to add or delete providers, as necessary, throughout the term of the Agreement. The Internal Services Department - Purchasing concurs with the Department’s request to waive the competitive bidding process.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The total contract compensation will not exceed $11,844,000. Costs will be financed with Behavioral Health Realignment funds. Sufficient appropriations and estimated revenues will be included in the FY 2020-21 Recommended Budget and will be included in subsequent fiscal year budget requests.
DISCUSSION:
On July 14, 2015, your Board approved Master Agreement No. 15-316 with Licensed TRSP’s to provide a higher level of care to mental health clients with persistently severe mental illness and minimized their risk of hospitalizations while also providing enhanced services to assist clients with the development of independent living skills promoting movement toward less structured settings. The recommended Master Agreement will allow the Department to continue to provide clients with TSRP services and placement and continue to allow the Department’s Director to add and/or delete providers as deemed necessary by clinical staff based on client placement needs and geographical location.
Through the recommended Master Agreement, the facilities rates vary from $149 to $203 per day for TSRP services provided to select mental health clients placed by the Department’s clinical staff. As of March 3, 2020, 26 clients were placed within TSRP facilities. Actual costs will be determined by usage but will not exceed the total amount specified for each fiscal year throughout the duration of the Master Agreement, total compensation not to exceed $11,844,000. The recommended Master Agreement includes language which allows for the Department’s Director to negotiate rates with TSRP contractors and add and/or delete licensed TSRP facilities without affecting the compensation paid to other contractors. All qualified, licensed and interested vendors will be added to the Master Agreement to meet the department’s placement needs as assessed by clinical staff and can be terminated by either party upon providing a 30-day advance written notice.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended Master Agreement at their April 9, 2020 meeting.
REFERENCE MATERIAL:
BAI #48, June 20, 2017 - Amendment I to Master Agreement No. 15-316
BAI #34, July 14, 2015 - Master Agreement No. 15-316
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Master Agreement with Licensed Social Rehabilitation Facilities
Suspension of Competition
CAO ANALYST:
Ronald Alexander