DATE: September 10, 2024
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment IV to Master Agreement with Institution of
Mental Disease (IMD) Facilities including Skilled Nursing Facilities
(SNFs), Geropsychiatric Nursing Care Facilities (GNCFs), IMDs, and
Mental Health Rehabilitation Centers (MHRCs)
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment IV to Master Agreement to modify Exhibit C for 7th Avenue Center, LLC; Helios Healthcare, LLC, d.b.a. Idylwood Care Center; and Mental Health Management I, Inc., d.b.a. Canyon Manor, to include bed hold rates and update bed hold language expanding permissions for the placement of a bed hold to include both psychiatric and non-psychiatric reasons, effective upon execution with no change to the term of July 1, 2021 to June 30, 2026, or compensation maximum of $133,577,211.
REPORT
There is no additional Net County Cost associated with approval of the recommended action, which will allow the Department to add bed hold rates for these three providers and update their rate sheets to match the standardize bed hold language for all providers on the agreement. This item is countywide.
ALTERNATIVE ACTION(S):
Should the Board not approve of the recommended action, the Department would not be able to place a bed hold for persons served at Helios Healthcare, LLC, d.b.a. Idylwood Care Center and Mental Health Management I, Inc., d.b.a. Canyon Manor and will be unable to request a bed hold from 7th Avenue Center, LLC or Mental Health Management I, Inc., d.b.a. Canyon Manor for persons served who require emergency placement at an acute psychiatric hospital or psychiatric health facility.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation for FY 2024-25 is $29,121,762. The maximum compensation for the term of the agreement is $133,577,211. The recommended agreement is funded with Mental Health Realignment. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2024-2025 Recommended Budget and will be included in future budget requests. Actual costs will be determined by actual services provided.
DISCUSSION:
On July 13, 2021, your Board approved Master Agreement No. A-21-258 with licensed and credentialed facilities to provide beds and services at the appropriate level of care secured Skilled Nursing Facilities (SNF), Geropsychiatric Nursing Care Facilities (GNCF), Institutions of Mental Disease (IMD), and Mental Health Rehabilitation Centers (MHRC) to County adults living with severe and persistent mental health conditions, as mandated by the WIC and CCR Title 22.
On February 7, 2023, your Board approved Amendment I No. A-23-059 to the Master Agreement to add a local skilled nursing facility. On June 20, 2023, your Board approved Amendment II No. A-23-315 to the Master Agreement to add another local skilled nursing facility and two additional out-of-county skilled nursing facility. On July 9, 2024, your Board approved Amendment III No. A-24-368 to the Master Agreement to add additional enhanced services for Conservatees to the rate sheet of a currently contracted provider.
As the need for services continues to increase annually, the DBH Conservatorship Team has continuously sought new providers to expand the County’s network. Additionally, for currently contracted providers such as those listed above, the DBH Conservatorship Team requires the ability to place a bed hold for psychiatric and non-psychiatric reasons to ensure a person served does not lose their placement in the facility. The bed hold language for these three providers is being updated to match the language present in all other provider rate sheets.
Approval of the recommended action will allow for the update of these three provider-specific rate sheets to include the appropriate bed hold language and add a bed hold rate for the providers who previously have not included said rate in their corresponding Exhibit C.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended agreement at their August 2024 meeting.
REFERENCE MATERIAL:
BAI # 28 - July 9, 2024
BAI # 53 - June 20, 2023
BAI # 29 - February 7, 2023
BAI # 31 - July 13, 2021
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment IV to Master Agreement
CAO ANALYST:
Ronald Alexander