DATE: November 5, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health
SUBJECT: Amendments due to Relocation of Psychiatric Health Facilities and associated Agreements including LPS Resolution
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute Amendment 1 to Agreement 22-306 with Exodus Recovery, Inc. to modify the location where adult acute inpatient psychiatric health facility services are provided from 4411 E. Kings Canyon Road, Fresno, CA 93702 to the new location at 3127 N. Millbrook Avenue, Fresno CA 93703, modify the budget for additional resource availability, and make revisions to the insurance requirements, effective upon execution with no change to the term of July 1, 2022 through June 30, 2027, and increasing the maximum by $107,929 to a total of $32,425,668; and
2. Adopt Resolution restating Lanterman-Petris-Short Act designated facilities to update facility addresses within the County of Fresno, authorize psychiatric evaluation and treatment of persons, and authorize the local mental health director to provide 5150 training and certification of licensed and unlicensed professional persons under the Act.
REPORT
There is no Net County Cost associated with the recommended actions, which will allow Exodus Recovery, Inc. (Exodus) to continue to provide adult acute inpatient psychiatric health facility (PHF) services at the new location within the county-leased building at 3127 N. Millbrook Avenue. The second action will provide Lanterman-Petris-Short Act (LPS) designation for adult and youth PHFs’ new locations within a county-leased building at 3127 N. Millbrook Avenue and 3115 N. Millbrook Avenue, in Fresno. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions. Should the Board not approve the recommended actions, Exodus would not be able to relocate to the newly renovated PHF and would have to continue to provide services at the current location.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The first recommended amendment has a total maximum compensation not to exceed $32,425,668 over the remaining agreement term through June 30, 2027 and will be fully offset with Medi-Cal Federal Financial Participation (FFP) and Mental Health Realignment funds. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-25 Adopted Budget and will be included within future budget requests for the duration of the contract term.
DISCUSSION:
On July 12, 2022, your Board approved Agreement No. 22-306 with Exodus to provide 24-7 adult inpatient psychiatric health facility services, and a Facility Use Agreement (FUA) for County-owned property located within the University Medical Center (UMC) Campus at 4411 E Kings Canyon Road in Fresno, where the adult PHF operated.
The Kings Canyon UMC Campus has been sold and requires the Adult PHF and the Adolescent PHF to relocate. The County leases the building with an address of 3109, 3115, 3119, 3121, 3127, 3133, 3147, 3151, and 3155 N. Millbrook Avenue, Fresno CA 93703 and 3676 and 3708 E. Shields Avenue, Fresno, CA 93726 (collectively, the “Building”), and intends to relocate its Adult PHF to 3127 N. Millbrook Avenue, Fresno, CA 93703, (13,519 square feet). Both PHF Contractors have been working with the County in relocation efforts of their respective PHFs.
Approval of the first recommended action will allow Exodus to continue operating the 16-bed adult acute inpatient PHF at the new location with an expected construction completion date in December 2024. Occupancy date is contingent upon Department of Health Care Services (DHCS) licensing and regulatory approvals. Referrals for adults 18 years of age and older are sent by the Department, other County departments, hospitals, and community organizations. The original Agreement and Facility Use Agreement (FUA) contained sufficient language to identify the new location, circumventing the need for a new FUA upon relocation. The increase to the total contract budget is for relocation costs, salary adjustments for SB 525 and market changes, and minor adjustments to accurately reflect costs for the new location. Furthermore, the Amendment updates the insurance language to meet current coverage requirements and adds All Risk Property Insurance.
Approval of the second recommended action will restate LPS Designated Sites with updated addresses for the Adult and Adolescent Youth PHFs and continue the Board’s prior authorization of the Local Mental Health Director, or designee, to provide appropriate §5150 training and certification to qualified unlicensed professionals. Unlicensed professional staff include medical residents working at local hospitals, marriage and family therapist interns, and associate clinical social workers working for the Department of Behavioral Health or in a County approved §5150 designated site. The §5150 designated sites include local hospital emergency departments, LPS Designated Facilities, and select outpatient mental health programs contracted with the County that employ medical and mental health professionals in direct client care with high acuity psychiatric issues. Existing authorized professional staff includes licensed physicians, licensed/waivered psychologists, registered and licensed vocational nurses, licensed clinical social workers, licensed psychiatric technicians, and licensed marriage and family therapists.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of the recommended Amendments and Facility Use Agreement during their August 2024 meeting.
REFERENCE MATERIAL:
BAI #36 July 12, 2022
BAI #36 June 23, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 1 to Agreement 22-306 with Exodus
On file with Clerk - Resolution
CAO ANALYST:
Ronald W. Alexander, Jr.