DATE: June 10, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment to Extend Kings View Mobile Crisis Response Agreement
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment No. 2 to Agreement No. 24-148 with Kings View for mobile crisis response and crisis intervention services, extending the term by one year, which includes a six-month base term and an optional six-month extension, from July 1, 2025, through June 30, 2026 and increasing the maximum by $7,825,705 to a total of $18,329,104; and
2. Approve and authorize the Chairman to execute Amendment No. 3 to License Agreement No. 24-041 with Kings View to extend the use of the County’s Health and Wellness Center, 1925 E Dakota Ave. Fresno, CA 93726, for one-year, which includes a six-month base term and an optional six-month extension, from July 1, 2025, through June 30, 2026 ($0).
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of recommended action one will extend the term of the Agreement by one year and increase the maximum compensation by $7,825,705 to continue to provide mandated mobile crisis response and crisis intervention services. Recommended action two will extend the corresponding license agreement by one year. These recommended amendments will allow the Department to utilize services provided by Kings View until a new contract is adopted. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. If your Board does not approve recommended action one, the Department will not be in compliance with Department of Health Care Services (DHCS) mandated services for mobile crisis response and crisis intervention services. Furthermore, individuals actively experiencing a behavioral health crisis will not receive the care they need.
For both recommended actions, your Board may direct the Department to assume operations of mobile crisis services; however, the decision will result in added costs to the County and a delay in services as the Department obtains the required staff.
FISCAL IMPACT:
There is no increase to Net County Cost associated with the recommended actions.
The first recommended action increases the maximum compensation by $7,825,705 for the extension of the agreement to a total maximum compensation to $18,329,104. The Agreement is funded with Mental Health Realignment, Mental Health Services Act Prevention and Early Intervention (MHSA-PEI), California Health Facilities Finance Authority (CHFFA) grant funding, Medi-Cal Federal Financial Participation (FFP) revenue and Drug Medi-Cal FFP revenue.
The second recommended action has no cost associated. Approval of the second recommendation action will allow Kings View to continue to use the Medi-Cal site certified office to provide services and bill to Medi-Cal.
Sufficient appropriations and estimated revenues will be included in the Department of Behavioral Health Org 5630 FY 2025-26 Recommended Budget.
DISCUSSION:
Crisis Intervention Team and Mobile Crisis Response Team Agreement Background
On December 11, 2018 the Board approved Agreement No. 18-688 with Kings View to provide Crisis Intervention Team (CIT) services in the Fresno metropolitan (Metro) Rural areas. Services include, but are not limited to, assessment, crisis intervention, community referrals and linkages, and short-term/brief case management. CIT clinicians are dispatched in response to behavioral health crisis calls in the community with law enforcement.
On June 21, 2022, the Board approved Agreement No. 22-266 with Kings View for CIT services in Fresno rural areas
On June 20, 2023, the Board approved Supersede Agreement No. 23-303 and No. 23-308 of the Metro and Rural agreements, respectively, with Kings View to implement DHCS California Advancing and Innovating Medi-Cal (CalAIM) regulations.
On January 23, 2024, the Board approved Amendment I No. 24-039 to Metro Agreement No. 23-303 and Amendment I No. 24-040 to Rural Agreement No. 23-308 to add Mobile Crisis Response Team (MCRT) services as mandated by DHCS Medi-Cal Mobile Crisis Benefit Services. MCRT services include a dedicated 24/7 mobile crisis hotline and two-member team response to non-law enforcement related behavioral health crisis calls in the community.
On April 9, 2024, the Board approved Supersede Agreement A-24-148 with Kings View to combine Metro and Rural services in one agreement and to provide crisis intervention service with co-response with law enforcement, mobile crisis response, community referrals and linkages, and short-term/brief case management. MCRT services are mandated by DHCS as described above. CHFFA funds were included to the agreement for a better coordinated mobile crisis intervention system of care, leverage more flexible staffing strategies, and reduce additional administrative burden.
On August 20, 2024, the Board approved Amendment I to A-24-148 to Agreement No. A-24-439, to expand the use of dedicated school staff and to add Crisis Care Mobile Units grant funds. The updated Scope of Services for the school-based mobile crisis services will allow the school-based teams to support children and youth experiencing a behavioral health crisis out in the community during periods where schools are not in session.
In FY 2023-2024, 3531 individuals were served and for the period of July 2024-December 2024, 2,010 individuals were served.
License Agreement Background
On December 23, 2021, the Board approved License Agreement No. D-21-560 to allow Kings View to co-locate in County’s Health and Wellness Center (HAWC) located at 1925 E. Dakota Ave, Fresno, CA 93726.
On June 20, 2023, the Board approved Amendment I (A-23-304) to License Agreement No. D-21-560 to extend the term of the agreement.
On January 23, 2024, the Board approved Amendment II (A-24-041) to License Agreement No. D-21-560 to allow the Kings View to expand use of the HAWC to 24 hours a day, 7 days a week, and 365 days a year.
Recommended Action Discussion
A Request for Proposal (RFP) 25-075 for Community Behavioral Health Response Services was issued March 20, 2025 and closed on April 18, 2025. Proposals are currently being evaluated by Purchasing and the Department.
These Amendments will ensure uninterrupted services are provided timely to County persons served by allowing the Department to continue to utilize Kings View’s mandatory services as needed while the RFP process is finalized. Furthermore, should a new vendor be awarded the contract, the additional six (6) months of services will allow for a transition from the current contractor to the new selected bidder without disruption to the provision of services for County persons served. All provisions, terms, and conditions contained in this Agreement not amended shall remain unchanged and in full force and effect.
REFERENCE MATERIAL:
BAI #29, August 20, 2024
BAI #36, April 9, 2024
BAI #23, January 23, 2024
BAI #44, June 20, 2023
BAI #46, June 21, 2022
BAI #32, December 11, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 2 to Agreement No. 24-148 with Kings View
On file with Clerk - Amendment No. 3 to License Agreement No. 24-041 with Kings View
CAO ANALYST:
Ronald W Alexander, Jr.