DATE: July 9, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment III to Master Agreement with Institution of
Mental Disease (IMD) Facilities including Skilled Nursing Facilities
(SNFs), Geropsychiatric Nursing Care Facilities (GNCFs), IMDs, and
Mental Health Rehabilitation Centers (MHRCs)
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Retroactive Amendment III to Master Agreement adding CF Merced Behavioral, LLC, d.b.a. Merced Behavioral Center to the agreement, effective June 3, 2024, with no change to the term of July 1, 2021 to June 30, 2026, or compensation maximum of $133,577,211.
REPORT
There is no additional Net County Cost associated with approval of the recommended action, which will allow the Department to add CF Merced Behavioral, LLC, d.b.a. Merced Behavioral Center (MBC) to the master agreement for additional enhanced services. This item is countywide.
ALTERNATIVE ACTION(S):
Should the Board not approve of the recommended action, the Department would not be able to pay for urgently required services currently being provided to an adult Fresno County conservatee and will be unable to utilize the additional services provided by MBC such as the newly opened Behavioral Transitional Care Unit and the option of providing services for Murphy status Conservatees.
RETROACTIVE AGREEMENT:
An adult conservatee required urgent placement in a specific level of care. The Conservator Team was not able to find appropriate placement under the current service levels associated with this agreement. As the DBH Conservatorship Team sought an appropriate level of care, they were notified of the opening of MBC’s new Behavioral Transitional Unit. After extensive review, it was determined that this new service met the needs of this Fresno County conservatee. The Conservator Team is currently working with the facility to place the conservatee at the earliest available date during the process of preparing this amendment. Due to the nature and timeline of this placement, the Department requests the amendment be approved retroactively to June 3, 2024 to allow for payment of said necessary services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation in FY 2023-2024 is $26,474,329 and for FY 2024-25 is $29,121,762. The maximum compensation for the term is $133,577,211. The recommended agreement is funded with Mental Health Realignment. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-2024 Adopted Budget and will be included in future budget requests. Actual costs will be determined by actual services provided.
DISCUSSION:
On July 13, 2021, your Board approved Master Agreement No. A-21-258 with licensed and credentialed facilities to provide beds and services at the appropriate level of care secured Skilled Nursing Facilities (SNF), Geropsychiatric Nursing Care Facilities (GNCF), Institutions of Mental Disease (IMD), and Mental Health Rehabilitation Centers (MHRC) to County adults living with severe and persistent mental health conditions, as mandated by the WIC and CCR Title 22.
On February 7, 2023, your Board approved Amendment I No. A-23-059 to the Master Agreement to add a local skilled nursing facility. On June 20, 2023, your Board approved Amendment II No. A-23-315 to the Master Agreement to add another local skilled nursing facility and two additional out-of-county skilled nursing facility.
As the need for services continues to increase annually, the DBH Conservatorship Team has continuously sought new providers to expand the County’s network. Additionally, for currently contracted providers such as MBC, when notified of a potential addition of services, the DBH Conservatorship Team evaluates the need for such services and provides a recommendation based on the necessity. The team has determined the need for such services as a means of increasing the County’s network of available services and expanding the variety of communities current providers are capable of serving. Due to the specific need of an adult conservatee, the DBH Conservatorship Team will place the conservatee at the facility to begin receiving the appropriate level of care as soon as possible. Due to the nature and timeline of this placement, DBH requests the retroactive approval of this amendment to June 3, 2024.
Approval of the recommended action will add MBC to the master agreement to provide the aforementioned services.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended agreement at their June 2024 meeting.
REFERENCE MATERIAL:
BAI # 53 - June 20, 2023
BAI # 29 - February 7, 2023
BAI # 31 - July 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment III to Master Agreement
CAO ANALYST:
Ronald Alexander