DATE: November 7, 2023
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Retroactive Agreements with Various Providers for Term Extensions
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a retroactive Agreement with Central Star Behavioral Health, Inc. for operation of the 24/7 Youth Psychiatric Health Facility, effective July 1, 2023, not to exceed two consecutive years, which includes a one-year base contract and one optional one-year extension, total not to exceed $11,713,393.
2. Approve and authorize the Chairman to execute a retroactive Agreement with Kings View, Poverello House, and Centro La Familia Advocacy Services for Multi-Agency Access Program (MAP) services, effective July 1, 2023, not to exceed a one-year contract term, total not to exceed $900,000.
3. Approve and authorize the Chairman to execute a retroactive Agreement with University of California, San Francisco (UCSF) for psychiatric residency services, effective July 1, 2023, not to exceed two consecutive years, which includes a one-year base contract and one optional one-year extension, total not to exceed $895,555.
4. Approve and authorize the Chairman to execute a retroactive Memorandum of Understanding with UP Holdings California, LLC for identification, application, and development of permanent supportive housing services utilizing the No Place Like Home Program, effective July 1, 2023, not to exceed a one-year contract term ($0).
5. Approve and authorize the Chairman to execute a retroactive Amendment with Mental Health Systems, Inc. dba Turn Behavioral Health Service, for mental health and substance use disorder (SUD) services full service partnership (FSP) program, effective July 1, 2023, not to exceed two consecutive years, which includes a one-year base contract and one optional one-year extension, total not to exceed $1,331,892.
REPORT
There is no Net County Cost associated with the recommended actions, which will approve five retroactive agreements with various providers to continue to provide their respective services for persons served. Approval of the recommended actions will allow services to continue across the Department of Behavioral Health (DBH) continuum of care, including but not limited to a youth psychiatric inpatient facility, MAP, psychiatric residency, permanent supportive housing, and dual diagnosis mental health and SUD FSP services. The 60-day deadline to execute the first one-year extension was not met resulting in the agreement expiring on June 30, 2023. Approval of the recommended actions will allow services to continue based on the previously approved agreements. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Non-approval of the recommended actions would leave many persons served without access to services.
RETROACTIVE AGREEMENT:
The original agreements expired on June 30, 2023 when written approval for the extension years were not completed timely as indicated within each respective agreement. To continue services without interruption, retroactive agreements effective July 1, 2023 are required.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions.
The maximum cost of the first recommended action in FY 2023-24 is $5,770,144; $11,713,393 for the entire contract term. Services are funded by Medi-Cal Federal Financial Participation (FFP) and Mental Health Realignment funds. July ($363,117) and August ($438,590) invoices have been received and are pending payment totaling $801,707.
The maximum cost of the second recommended action in FY 2023-24 is $900,000; $10,300,000 for the entire contract term. Services are funded by Mental Health Services Act - Prevention and Early Intervention (MHSA - PEI) funds. There is a current pending invoice total of $141,636.76 for all contractors for this fiscal year.
The maximum cost of the third recommended action in FY 2023-24 is $438,995; $895,555 for the entire contract term. Services are funded by Mental Health Services Act - Workforce Education and Training (MHSA - WET) funds and Short-Doyle Medi-Cal Federal Financial Participation (FFP) funds. July ($13,333) and August ($14,445) invoices have been received and are pending payment totaling $27,778.
The fourth recommended action does not have any monetary compensation associated with the recommended Memorandum of Understanding.
The maximum cost of the fifth recommended action in FY 2023-24 is $665,946; $1,331,892 for the entire contract term. Services are funded by Mental Health Services Act - Community Services and Support (MHSA - CSS) funds.
Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2023-24 Adopted Budget and will be included within future budget requests for the duration of the contract terms. Total expenditures will be determined by actual services provided.
DISCUSSION:
The previously approved Agreements listed in the recommended actions included contract language that required written approval of both parties no later than 30 days prior to the next 12-month extension period. Unfortunately, this requirement was not met resulting in the above Agreements terminating as of June 30, 2023. This was brought to the Department’s attention in September 2023. Approval of the recommended actions will allow services to be provided without interruption based on the previously approved agreements. Mitigation strategies have been put into place to ensure compliance with the agreement language in the future.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was made aware of the recommended agreements during the September 2023 meeting.
REFERENCE MATERIAL:
BAI #39, June 20, 2023
BAI # 23, March 8, 2022
BAI #36, June 23, 2020
BAI #29, August 6, 2019
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Central Star Behavioral Health, Inc.
On file with Clerk - Agreement with Various Providers for MAP Services
On file with Clerk - Agreement with UCSF for Psychiatric Residency Services
On file with Clerk - Memorandum of Understanding with UPholdings LLC
On file with Clerk - Agreement with Mental Health Systems, dba TURN Behavioral Health
CAO ANALYST:
Ronald Alexander