DATE: November 8, 2022
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Agreement No. 18-699 with JDT Consultants, Inc. for Therapeutic Behavioral Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment I to Agreement with JDT Consultants, Inc. for an increase in service rates for the Therapeutic Behavioral Services program, effective upon execution with no change to the term of January 1, 2019 through June 30, 2023 or the maximum compensation of $18,300,000.
REPORT
Approval of the recommended action would allow the vendor to increase their service rates and salaries to align with industry trends and minimize staff turnover. The vendor has experienced high turnover rates, due to lower salaries, which has impacted their ability to provide quality and timely services. The recommended amendment would allow for an increase in per minute rates, with no increase to the overall compensation or Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
There is no alternative action. Should your Board not approve the recommended action, the vendor will continue with the currently contracted rates and salaries. Services may continue to experience high staff turnover rates and the timely delivery of crucial Therapeutic Behavioral Services to local high acuity youth will continue to be impacted.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended agreement ($18,300,000) and recommended amendment will be fully funded with Medi-Cal Federal Financial Participation (FFP), Behavioral Health Realignment, and Mental Health Realignment. Sufficient appropriations and estimated revenues are included in the Behavioral Health Org 5630 FY 2022-23 Adopted Budget. Approval of the recommended action will not increase the maximum compensation.
DISCUSSION:
On December 11, 2018, the Board approved Agreement No. 18-699 with JDT Consultants, for the provision of Therapeutic Behavioral Services (TBS) for the Department. The program provides one-to-one therapeutic contacts between a mental health specialist and youth who meet the program criteria and their families. TBS focus on behaviors and symptoms, which may jeopardize existing placements, or act as barriers to a lower level of residential placement or the completion of specific treatment goals. The TBS coach meets with clients at their home, school, or a place where the client is most comfortable, during times most therapeutic and when interventions are most needed.
JDT has experienced a high staff turnover rate for this program, impacting the ability to provide timely access to treatment services. Clinicians are hired and trained on a regular basis; however, JDT has experienced a trend of trained clinicians leaving to organizations that can compensate at a higher rate. Turnover impacts JDT’ s allocated training budget, as more funds are constantly needed to keep up with the demand of new hire trainings.
Additionally, JDT staff have experienced an increase in caseload ratios, as well as an increase in client acuity and clients in rural areas, which creates larger workloads for staff of this program. JDT has also experienced an increase in operational costs, including increases in rent, utilities, staff development costs, and staff mileage, largely due to inflation, since the beginning of this contract. The current service rate for TBS services is set at $2.00 per minute; this rate has not changed in 18 years, which has hindered JDT’s ability to account for rising costs of every kind. This rate increase to $2.30 per minute would help bring both the service rates and salaries to align with industry trends.
With your Board’s approval, the recommended amendment would result in an increase to the per minute rates and allow an increase to salaries and retain vendor staff. The program has a base contract term of three years with the option of two additional one-year renewals. The recommended action would increase the rate for FY 2022-23, upon execution, with no changes to the agreement terms and no increase to the maximum compensation.
REFERENCE MATERIAL:
BAI #36, December 11, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agreement No. 18-699 with JDT
CAO ANALYST:
Ronald Alexander