DATE: July 12, 2022
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Power Failure Emergency
RECOMMENDED ACTION(S):
TITLE
1. Authorize the Director of the Department of Behavioral Health, in coordination with the Internal Services Department and County Administrative Officer, if necessary, to expedite actions including any essential building alterations, fire clearances and Medi-Cal site certifications needed to relocate 24-7 services into temporary locations; and,
2. Ratify the Emergency Amendment to Agreements with Exodus Recovery, Inc., and Central Star Behavioral Health, Inc., previously executed on July 5, 2022, by the County Administrative Officer, acting as Emergency Services Director, adding stand by and alternative services for:
a. Exodus Recovery, Inc., Agreement No. 22-259 for adult and youth crisis stabilization center services with no change to the term of July 1, 2016, through June 30, 2022, and increasing the maximum compensation by $61,750 to a total of $74,069,233.
b. Exodus Recovery, Inc., Agreement No. 22-129 for operation of the adult acute inpatient psychiatric health facility with no change to the term of October 1, 2015, through June 30, 2022, and increasing the maximum compensation by $3,250 to a total of $28,996,921.
c. Central Star Behavioral Health, Inc., Agreement No. 20-238 for operation of the adolescent youth acute inpatient psychiatric health facility with no change to the term of July 1, 2020, through June 30, 2025, and increasing the maximum compensation by $175,866 to a total of $28,237,898.
d. Central Star Behavioral Health, Inc., Agreement No. 17-580 for adult mental health crisis residential treatment services with no change to the term of December 1, 2017, through June 30, 2023, and increasing the maximum compensation by $108,251 to a total of $11,775,631.
REPORT
There is no Net County Cost associated with the recommended actions. Approval of the recommended actions will allow, if necessary due to the power failure, Exodus Recovery, Inc. (Exodus), to temporarily relocate and continue operating 24-7 crisis stabilization centers (CSC) for adults and youth admitted for services on a voluntary or involuntary basis. In addition, approval would allow, if necessary due to the power failure, Exodus to temporarily relocate and continue operating a 24-7 acute inpatient psychiatric health facility (PHF) for adults. Additionally, approval would also allow Central Star Behavioral Health, Inc. (Central Star), if necessary due to the power failure, to temporarily relocate and continue operating a 24-7 acute inpatient PHF for youth admitted on a voluntary or involuntary basis. Any relocations, if necessary for any facility, would be contingent on identification of appropriate property that is capable of achieving required licensure at minimal cost. Lastly, approval would allow Central Star to continue to operate a 24/7 Mental Health Crisis Residential Treatment Services (CRT) facility for adults admitted on a voluntary basis. The facilities operate in separate areas within the county-owned buildings located at 4411 E. Kings Canyon Road, Fresno, CA 93702 and 496 S Barton Ave, Fresno, CA 93750 (UMC campus). These buildings are located in District 3, but the services are available to individuals countywide.
ALTERNATIVE ACTION(S):
If the power failure, reoccurs and remains unresolved, there will be no alternative actions as the Department will not be able to continue providing crisis stabilization and acute inpatient 24-7 mental health services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The combined increase of the amendments is $349,117. The Exodus Agreements will increase by $61,750 and $3,250. The Central Star agreements will increase by $175,866 and $108,251. The increase will be funded with Net County Cost as the services to be covered may not be reimbursable with Department funds. If expedited actions including any essential building alterations, fire clearances and Medi-Cal site certifications are needed to relocate 24-7 services into temporary locations, the Department will return to your Board for approval or ratification of the related actions and appropriations. Sufficient appropriations and estimated revenues are included in the Departments Org 5630 FY 2021-22 Adopted Budget and will be funded with Behavioral Health Realignment (Realignment) and Federal Financial Participation (FFP) funds ($349,117).
DISCUSSION:
The power failure that happened overnight, between June 17 and 18, 2022, at the UMC campus disrupted services at the CSCs and PHFs. Due to extreme heat in the buildings and lack of interior lighting, on Monday June 20, 2022, the Department and contracted partners initiated emergency relocation of clients to local emergency departments, other inpatient psychiatric hospitals, residential placements, and other expedited safe discharges. Since then, the Department has worked with Central Star and Exodus to continue decreased operation of mental health services. However, while the services were offline and are now being reintegrated, the emergency departments at the local hospitals have been impacted due to the ongoing COVID-19 public health emergency and the intake of persons experiencing mental health crises.
Since June 18, 2022, the UMC campus has experienced sporadic power outages that have resulted in power failure to the CSCs and PHFs supply and equipment. Approval of the recommended actions will allow the Department to engage necessary actions in coordination with the Internal Services Department and County Administrative Officer.
REFERENCE MATERIAL:
BAI #40, June 21, 2022
BAI #37, April 5, 2022
BAI #36, June 23, 2020
BAI #31.1, April 28, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Emergency Amendment to Agreement with Exodus
On file with Clerk - Emergency Amendment to Agreement with Central Star
CAO ANALYST:
Sonia M. De La Rosa