DATE: June 18, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment No. 1 to Service Agreement No. 23-274 with Turning Point of Central California, Inc. for the provision of Rural Mental Health Services
RECOMMENDED ACTION(S):
TITLE
Approve and Authorize the Chairman to execute Retroactive Amendment No. 1 to Agreement with Turning Point of Central California, Inc. to update the physical site locations for the provision of Mental Health Services Act (MHSA) Rural Mental Health (RMH) Services Full Service Partnership Services, Outpatient Mental Health Services, and Intensive Case Management Services in rural Fresno County for children that have severe emotional disturbance and adults that have a serious mental illness, effective April 5, 2024 with no change to the term of July 1, 2023 through June 30, 2025, or maximum compensation of $31,581,546.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health (DBH) and the contracted provider, Turning Point of Central California, Inc. (Turning Point), to continue providing RMH services to persons served in the Rural areas of Fresno County. Turning Point has shown that the physical rural sites in Huron and Mendota should be closed as they are unable to sustain the costs with limited revenue being collected for those locations. All persons served at Huron and Mendota will still be served at nearby Coalinga and Kerman offices, respectively. This item pertains to Districts 1 and 4.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should your Board not approve the recommended action, the RMH services will not be able to continue providing services in the physical Huron and Mendota site locations due to budgetary constraints that arose out of the recent CalAIM Payment Reforms, effective July 1, 2023, which changed all services to be paid fee for services versus operational cost.
RETROACTIVE AGREEMENT:
Turning Point had to close the physical site locations in Huron and Mendota before this Amendment could be brought before your Board for approval. Last RMH Services provided at the physical clinic site locations listed above ended effective April 5, 2024, but services continue for persons served living in the Huron and Mendota rural areas of Fresno County at the Coalinga and Kerman offices, respectively. DBH is seeking to approve the Amendment which details the site closures retroactively to April 6, 2024.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation for the entire contract term will remain $31,581,546. The Agreement is funded with Medi-Cal Federal Financial Participation, Mental Health Realignment, and Mental Health Services Act (Community Services and Supports) funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget and will be included in future budgets for the duration of the contract term. Actual costs will be determined by actual services provided.
DISCUSSION:
On June 20, 2023, your Board approved Agreement No. 23-274 with Turning Point of Central California, Inc. to provide Full Service Partnership, Outpatient, and Intensive Case Management Services to the rural areas of Fresno County. Services were being provided effective July 1, 2023 out of Pinedale, Reedley, Sanger, Selma, Kerman, Coalinga, Huron and Mendota physical clinic site locations.
Turning Point sent Fresno County DBH a letter indicating the need to close the Huron Clinic site on December 13, 2023. They followed up the letter with a second dated January 24, 2024 indicating the need to close the Mendota site location.
Effective April 6, 2024, the Huron and Mendota rural site clinics stopped providing services to Huron and Mendota persons served as all Huron and Mendota caseloads had been transitioned to the Coalinga and Kerman sites respectively. The Huron and Mendota site locations needed to be closed in order to make the most cost-effective decisions to be able to continue services to persons served in the rural areas. If the recommended action is approved, services will continue to be provided in Pinedale, Reedley, Sanger, Selma, Kerman and Coalinga physical locations to all persons served in the rural areas of Fresno County but will not be limited to services provided in the physical clinic site locations.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended Amendment at the May 15, 2024 meeting.
REFERENCE MATERIAL:
BAI #44 June 20. 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 to Agreement with Turning Point
CAO ANALYST:
Ron Alexander