DATE: May 26, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Master Agreement for Behavioral Health Client Transportation Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute a Master Agreement with qualified medical transportation vendors for behavioral health clients, effective July 1, 2020, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $3,000,000.
2. Authorize the Department of Behavioral Health Director or designee to add and/or delete vendors to the Master Agreement, to negotiate and approve rates based on published charges and/or prevailing market rates for mental health client transportation services.
REPORT
Approval of the recommended actions will allow the Department of Behavioral Health (DBH) to contract with qualified medical transportation vendors for behavioral health clients. The Master Agreement provides DBH with the flexibility to provide authorized client transportation services and increase availability at all times for transportation both within the County to out-of-county behavioral health facilities on an as needed basis. To meet the needs of the clients, with your Board’s approval, the DBH Director or designee will be able to add and/or delete vendors who meet the requirements of the Request for Quote (RFQ) and negotiate rates based upon the published charges and/or prevailing market rates without additional Board action or increasing the contract amount.
ALTERNATIVE ACTION(S):
The services provided under the recommended Master Agreement cover 24 hours / 7 days per week for authorized client transportation both within the county and out-of-county and are based on actual prior year expenditures and the anticipated increase in client need.
1. Your Board has the option of adjusting the amount of the Master Agreement which could require a corresponding adjustment of service hours.
2. Your Board also has the option of utilizing County drivers only, resulting in possible service delays due to the limited number of two county drivers available to DBH for these services and only during the hours of 8:00 A.M. to 5:00 P.M., Monday through Friday, at a higher cost, and increased liability of transportation services to the County. Depending on scheduling conflicts, with this alternative, additional driver positions may need to be added to DBH.
Non-approval of the recommended Master Agreement will impact existing Agreements with other mental health providers (i.e. Merced County Psychiatric Health Facility and Kaweah Delta Inpatient Psychiatric Hospital) that require the County to provide transportation services to and from their respective facilities. Administrative cost increases would also result due to patients potentially having to wait longer periods for transportation.
FISCAL IMPACT:
There is no increase to Net County Cost associated with the recommended actions. The maximum cost of the recommended Master Agreement ($3,000,000) will be funded with Mental Health funds. Sufficient appropriations and estimated revenues will be included in the FY 2020-21 Recommended Budget at a maximum annual cost of $600,000 for DBH Org 5630 and will be included in future requested budgets for the duration of the term. Actual costs will be determined by actual services provided.
DISCUSSION:
On an as needed basis, DBH utilizes MHSA funding to provide authorized transportation services to behavioral health clients.
For the recommended Master Agreement, the qualified vendors include non-emergency medical transportation service providers. The vendors will provide transportation to approved behavioral health clients who do not have the ability or support to travel to or from the County for treatment. The services include transportation for clients discharged from hospital facilities outside of the County to locations within the County, picking up or delivering clients to a residence or alternative location as per facility discharge instructions. The locations of designated facilities outside the County may include, but are not limited to, Visalia, Bakersfield, Merced, Ventura, and Sacramento. The Master Agreement will allow DBH to have vendors available on a 24-hour / 7 day a week basis to fill the requests for DBH within a specified time frame dependent on the day of request. The transportation services include behavioral health clients who may have medical needs, wheelchairs, walkers, or other medical devices.
From July 1, 2015 through February 29, 2020, through Agreement No. 15-256-1, a total of 1,846 authorized transports were completed, with one or more clients per trip, by On-Call Transport, Inc., the existing provider. The Agreement is scheduled to expire June 30, 2020. Additionally, DBH has two assigned County drivers who provide transportation services Monday through Friday from 8:00 A.M. to 5:00 P.M. with the balance of the transportations and scheduled conflicts fulfilled by On-Call Transport, Inc. Actual costs will be based on a fixed fee schedule and dependent upon actual services provided.
A Request for Quotation (RFQ) for mental health client transportation services was issued on January 31, 2020, and closed on February 26, 2020. The RFQ was emailed to three (3) qualified vendors and published on the County Purchasing internet site. The RFQ required prospective vendors to submit an application to provide transportation services for County adult and adolescent behavioral health clients. DBH requested that services be available 24 hours a day, 7 days a week to provide authorized transport services for mental health clients from Fresno County to out-of-county mental health facilities and scheduled transportation from out-of-county to Fresno County mental health facilities on an as-needed basis.
Based upon the review of the four responses received, DBH recommends that your Board authorize and approve the Chairman to execute this Master Agreement and allow the Director to add qualified vendors when a determination is made that the need exists and/or additional vendors are required without increasing the contract amount. The initial providers are On-Call Transport, INC and Fresno Economic Opportunities Commission. The Master Agreement will provide DBH with services to meet the need for local, long distance and other behavioral health client transportation needs. Dependent on the specific request, DBH will select the most cost-effective vendor as rates are based on response call and mileage. Coverage needs are unpredictable and having the recommended Master Agreement in place will allow the department to provide coverage when needed.
Approval of the recommended Master Agreement will allow the department to ensure timely and effective services to meet wellness and recovery needs of behavioral health clients. DBH will have the option of choosing from multiple vendors to provide necessary transportation services to DBH clients for the period of July 1, 2020 through June 30, 2023, with an option for two one-year renewals. The recommended Agreement may be terminated by the County with sixty (60) days advance written notice to respective vendor(s).
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of the recommended Agreements and actions during the May 2020 meeting.
REFERENCE MATERIAL:
BAI #44, June 16, 2015 - Agreement No. 15-256
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Master Agreement for Non-Emergency Transportation
CAO ANALYST:
Ron Alexander