DATE: May 6, 2025
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 4 to Master Agreement for Specialized Residential Mental Health Services
RECOMMENDED ACTION:
TITLE
Approve and authorize the Chairman to execute Amendment No. 4 to Master Agreement No. 24-441 to update Psynergy Programs, Inc. rate sheet with no change to the term of July 1, 2023 through June 30, 2025, or compensation maximum of $13,500,000.
REPORT
Approval of the recommended action will allow the Department of Behavioral Health to update the rate sheet for Psynergy Programs, Inc. (Psynergy) to align with the current Department reimbursement process. In addition, approval will also include payment for the Supplemental Social Security Income (SSI)/State Supplementary Payment (SSP) equivalent for basic services for non-benefited persons served (persons currently not receiving federal funding from SSI/SSP). This item is countywide.
ALTERNATIVE ACTION:
Should your Board not approve the recommended action, the Department would not be able to appropriately reimburse Psynergy the SSI equivalent for basic services for non-benefited persons served.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation in FY 2024-25 is $7,000,000. The maximum compensation for the term is $13,500,000. The agreement is funded with Mental Health Realignment. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Adopted Budget. Actual costs will be determined by actual services provided.
DISCUSSION:
On August 20, 2019, the Board approved Master Agreement No. 19-406 with licensed and credentialed facilities to provide specialized residential mental health services for County persons served, as mandated by the Welfare and Institutions Code (WIC) and California Code of Regulations (CCR) Title 22.
On June 30, 2023, the Board approved Superseding Agreement No. 23-283 to include new California Advancing and Innovating Medi-Cal (CalAIM) requirements set by the Department of Health Care Services including payment reform requirements.
On August 22, 2023, the Board retroactively approved Amendment No. 1 (No. 23-415) to revise Exhibit B-5 for provider Star View Behavioral Health, Inc. whose CalAIM determined rates were modified by their host County.
On March 5, 2024, the Board approved Amendment No. 2 (No. 24-100) to the Master Agreement to add BHC Alhambra Hospital, Inc. d.b.a. BHC Alhambra Hospital, an out-of-County eating disorder provider.
On August 20, 2024, the Board approved Amendment No. 3 (No. 24-441) to the Master Agreement to add Central Star Behavioral Health, Inc. and remove Crestwood Behavioral Health, Inc.
Persons served receiving services at Psynergy are conservatees of Fresno County. The conservatorship team places individuals at Psynergy based off the Clinical needs of each persons served. Currently, SSI reimbursement for persons served who receive SSI (benefited persons served) is issued via the Public Guardians Office. There is no mechanism in place to reimburse Psynergy the SSI equivalent for persons served who do not receive SSI (non-benefited persons served).
CCR, Title 22, Section 80001, subsection b, defines the basic rate as the rate charged by facilities to provide basic service. For SSI/SSP recipients, the basic rate is determined as the established nonmedical out-of-home care rate which includes any exempt income allowance but does not include that amount allocated for the recipient's personal and incidental needs. Basic services are defined by CCR to mean those services required by applicable law and regulation to be provided by the licensee in order to obtain and maintain a community care facility license. The proposed amendment would allow the Department to revise the rate sheet for Psynergy to allow reimbursement of the SSI equivalent for basic services for non-benefited persons served placed at the provider’s facilities at the annually negotiated SSI basic services reimbursement rates set forth by the California Department of Social Services, via the Agreement. The SSI equivalent reimbursement covers the cost of Room and Board/Care and Supervision services, also referred to as the Basic Services rate. Revised Exhibit B-6-3 will replace the current Revised Exhibit B-6-2 in full, upon approval.
REFERENCE MATERIAL:
BAI #31 August 20, 2024
BAI #30 March 5, 2024
BAI #26 August 22, 2023
BAI #44 June 20, 2023
BAI #26 August 20, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 4 to Master Agreement
CAO ANALYST:
Ronald Alexander Jr.