DATE: March 5, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Termination of Mental Health Patient Right’s Advocate Program Agreement
RECOMMENDED ACTION(S):
TITLE
Retroactively authorize the Director of the Department of Behavioral Health’s previous submission of a 60-day written notice to Mental Health Patient’s Rights Advocate Program to terminate Agreement No. 23-079, pursuant to the Without Cause provision of the Agreement, to be effective March 15, 2024.
REPORT
There is no increase in Net Count Cost associated with the recommended action, which will allow the County to terminate its agreement with Mental Health Patient’s Rights Advocate Program (MHPRAP) pursuant to Section 3.C of the agreement, termination without cause. The Director of the Department of Behavioral health sent the 60-day written notice to terminate the agreement with MHPRAP on January 10, 2024 with an effective date of March 15, 2024 subject to your Board’s approval. The program has faced numerous challenges in meeting contractual reporting and insurance requirements. This item is countywide.
ALTERNATIVE ACTION(S):
If the recommended action is not approved, the agreement would continue for the full five-year term and shall terminate June 30, 2025
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended action will terminate the agreement. The five-year agreement has a maximum compensation of $1,476,337. The amount estimated to be paid to contractor for FY 2023-24 through March 15, 2024 is $171,402, allowing a cost savings of $105,632. The unspent funds will be utilized to acquire services with a new contractor for the remainder of FY 2023-24.
DISCUSSION:
Mental Health Patient Rights Advocacy is a mandated service per Welfare & Institution Code Sections 5520-5523. The targeted population are adults and youth who are voluntarily or involuntarily admitted to Lanterman-Petris-Short (LPS) designated facilities and non-designated facilities.
On November 19, 2019, your Board approved agreement No. 19-586 with MHPRA to commence January 1, 2020. This program represents persons served in Mental Health patient rights advisements and Certification Review Hearings at designated facilities. In addition, the program provides complaint and grievance investigation and resolution for the persons served along with various advocacy activities.
On February 28, 2023, your Board approved Amendment I No. 23-079 to the MHPRAP agreement to include AB 2275 requirements. AB 2275 amended various section of the Welfare and Institutions Code under the LPS Act. The changes applied to the process for involuntary detentions and certification review hearings. MHPRAP shall now provide services to mental health persons served at non designated facilities, such as hospitals and crisis stabilization centers, for those meeting criteria established under the new Assembly Bill. This increased the volume of patient rights advisements and Certification Review Hearing representation.
MHPRAP has faced many challenges. The Fresno County Department of Behavioral Health (DBH) began discussing compliance issues regarding certificate of insurance requirements, facility monitoring, and mental health trainings and expectations with MHPRAP in July 2021 on a monthly basis. The program has not been able to obtain the insurance coverages, and additionally, has not been able to provide the facility monitoring or mental health training activities as outlined in the executed agreement. The programs challenges continued to increase upon execution of Amendment I for the implementation of AB 2275 requirements. The contracted provider has been unable to provide monthly or quarterly reporting of services rendered as of January 2023.
On August 30, 2023, DBH issued an official out of compliance notification to the provider. During this time, MHPRAP has been unable to effectively collaborate and demonstrate improvement.
Approval of the recommended action will terminate the agreement with MHPRAP utilizing the without cause provision of the agreement, effective March 15, 2024.
OTHER REVIEWING AGENCIES:
The Behavioral Health board was informed of the intent to terminate on the February 21, 2024 Behavioral Health Board meeting.
REFERENCE MATERIAL:
BAI #33, February 28, 2023
BAI #33, November 19, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MHPRAP Termination Letter
CAO ANALYST:
Ronald W. Alexander, Jr