DATE: July 9, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment II to Master Agreement for Specialized Supplemental Board and Care Home Services
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment II to Master Agreement to revise Supplemental Services rates and revise the Specialized Supplemental Board and Care Homes Scope of Work effective August 1, 2024 with no change to the term of July 1, 2022 to June 30, 2027 or the compensation maximum of $54,000,000.
REPORT
There is no additional Net County Cost associated with the recommended action, which will allow the Department to increase the Supplemental Services Rates for Fiscal Year 2024-2025 and will expand the list of services provided by Contractor(s) and listed in Revised Exhibit B. This item is countywide.
ALTERNATIVE ACTION(S):
Should the Board not approve the recommended action, the Department will not be able to revise rates, define services in the Scope of Work, or add monitoring language to ensure accountability for contractors.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation in FY 2024-25 is $10,800,000. The maximum compensation for the term is $54,000,000. The recommended agreement is funded with Mental Health Realignment and Community Mental Health Block Grant. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Recommended Budget and will be included in future budget requests. Actual costs will be determined by services provided.
DISCUSSION:
The Department, pursuant to Welfare and Institutions Code, section 5801 and the California Code of Regulations, Title 22, provides placements for conserved severely and persistently mentally ill adult persons served in secured certified/licensed facilities with the appropriate level of care and services. Specialized Supplemental Board and Care Homes are licensed Adult Residential Facilities (ARF) or Residential Facilities for the Elderly (RCFE). They are the least restrictive level of care for conserved persons that provide structured supportive and therapeutic housing that supports a seamless transition in preparing persons served to return to independence in the community free of institutional restrictions. The range of services in these facilities focus on the persons served wellness and recovery, working to facilitate returning or continuing to live in the community, and include medication management/education and self-care. Contracted ARF and RCFE facilities possess care exemptions from Community Care Licensing (CCL), which allows them to provide services to persons served with mental health disorders and a wide variety of specialized medical and behavioral needs.
On June 7, 2022, your Board approved Master Agreement No. 22-230 for Specialized Supplemental Board and Care Home Services. On June 20, 2023, your Board approved Amendment I to the Master Agreement, No. A-23-269, to add contractors, revise the compensation language, define bed holds, and add HR-Risk required revised clauses.
The Department determined the need to increase Supplemental Services Rates for Fiscal Year 2024-25, effective August 1, 2024, and revise the Specialized Supplemental Board and Care Homes Scope of Work to add a list of services that may be provided by Contractor(s) and monitoring language to increase accountability of services provided. Services were developed by the Conservator Team and, with approval of this agreement, will be added to the Scope of Work. This will allow the Department to monitor services provided more effectively.
Historically, Contractors on this agreement submit rates for the next Fiscal Year which are reviewed and approved by the Department executive team. Due to the fiscal climate and uncertainty of Realignment fund needs, a rate increase of 2% was approved by the Department’s executive team for Fiscal Year 2024-25. The range of daily rate reimbursement is $70.69 - $250.67 which is based on the number and type of services to conservatees. The Department’s Fiscal Team reviewed and trended expenditures on this Agreement and determined that there are sufficient funds to accommodate the increase without increasing the maximum compensation.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended amendment at their July meeting.
REFERENCE MATERIAL:
BAI #41, June 20, 2023
BAI #48, June 7, 2022
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment II to Master Agreement
CAO ANALYST:
Ronald Alexander