DATE: June 23, 2020
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
Robert W. Bash, Director of Internal Services/Chief Information Officer
SUBJECT: Agreement and Facility Use Agreement with Central Star Behavioral Health, Inc. for Adolescent Youth Psychiatric Health Facility Services
RECOMMENDED ACTION(S):
TITLE
1. Approve and authorize the Chairman to execute an Agreement with Central Star Behavioral Health, Inc. for an adolescent youth acute inpatient psychiatric health facility, 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 $28,062,032.
2. Approve and authorize the Director of Internal Services/Chief Information Officer to execute a Facility Use Agreement with Central Star Behavioral Health, Inc. effective July 1, 2020, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, for County owned space at 4411 E. Kings Canyon Rd, Fresno, CA 93702, Building 319 (7,069 square feet), to be used by Central Star Behavioral Health, Inc. to provide inpatient psychiatric health facility services to adolescent youth who may be admitted on a voluntary or involuntary basis.
REPORT
Approval of the recommended actions will allow the Department to continue to contract with Central Star Behavioral Health, Inc. (Central Star) to provide acute inpatient care services for youth and adolescents 12 to 18 years of age at a psychiatric health facility (PHF) located within a county-owned building at 4411 E. Kings Canyon Road in Fresno (County Building #319).
ALTERNATIVE ACTION(S):
There are no alternative actions. If the recommended actions are not approved, Central Star
would not be able to continue providing critical youth and adolescent psychiatric and other specialty mental health services at the identified county-owned facility.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The proposed PHF Agreement has a total maximum compensation not to exceed $28,062,032 over a 5-year period through June 30, 2025. The PHF Agreement will be financed with estimated Short/Doyle Medi-Cal Federal Financial Participation and Mental Health Realignment funds. Sufficient appropriations and estimated revenues will be included in the Department’s Org 5630 FY 2020-21 Recommended Budget and all subsequent budgets throughout the remainder of the contract term.
DISCUSSION:
On June 2, 2015, your Board approved the agreement for the first adolescent PHF in Fresno County. The purpose of the PHF is to provide an adolescent youth with acute crisis psychiatric and specialty mental health services in a coordinated and seamless system of care. The recommended Agreement with Central Star will continue to provide inpatient psychiatric services within the County rather than outsourcing to other existing out-of-county youth placement facilities. Traveling to out-of-county placements creates an undue hardship for youth and their families and higher contract costs for the County. If approved, this Agreement will continue to provide PHF services expecting to result in a continued reduction in the number of emergency room visits as well as stays at hospitals and crisis stabilization centers for adolescent youths with psychiatric symptoms.
On September 25, 2019, the Department issued Request for Proposal (RFP) No. 20-015 for Adolescent PHF Services. The RFP period closed on November 7, 2019. The Department received one bid: Central Star Behavioral Health, Inc. The Selection Review Committee (Committee) was comprised of three (3) members; a Clinical Supervisor from the Department’s Managed Care Division, a Clinical Supervisor from the Department’s Children Services Division, and a Fiscal Analyst from the Department’s Business Office. After discussion and review of Central Star’s bid proposal, the Committee came to an overall consensus that Central Star adequately meets the County’s RFP No. 20-015 requirements. The recommendation is based on the Committee’s review of the proposal, finding a fiscally adequate cost proposal budget and narrative, thorough knowledge of all related laws and regulations, knowledge and understanding of the Fresno County system, and a philosophy of approaching oversight of facilities as a collaboration and partnership with the County. The Committee unanimously agreed that Central Star can adequately operate an Adolescent Psychiatric Health Facility and will meet the needs of the Department.
Approval of the first recommended action will allow Central Star to operate the 16-bed youth and adolescent specific acute inpatient PHF. Referrals for the youth and adolescents 12 to 18 years of age will be sent by the Department. While prioritizing Fresno County residents, it is expected that Central Star will also contract for services with hospitals, community organizations and other county agencies to fill the beds.
For the first three-year base term of the recommended Agreement, the County will pay Central Star for operational net cost for up to 16 beds actually used by Fresno County DBH clients at the daily rates of $895.84 (FY 2020-21), $929.26 (FY 2021-22) and $957.13 (FY 2022-23), respectively. For the period of optional 1-year renewals thereafter (FY 2022-23 through FY 2024-25), County will pay Central Star for operational net cost for up to 16 beds actually used by Fresno County DBH clients at the daily bed rates of $985.85 (FY 2023-24) and $1,015.42 (FY 2024-25), respectively, upon satisfactory outcomes performance and subject to adequate funding each year.
If the recommended PHF Agreement is approved, Central Star will work with the Department’s Medical Director as well as with the University of California, San Francisco (UCSF) to plan and coordinate for the Child-Adolescent Fellowship program. Central Star will accept two Fellows per year (one at a time, for a 6-month rotation each) as well as Residents (one at a time, for a 2-month rotation each).
Approval of the second recommended action will allow Central Star to provide said acute inpatient care services on County-owned property located at 4411 E. Kings Canyon Road in Fresno (7,069 square feet) and to utilize private janitorial and security staff. There is no cost to Central Star for use of the County-owned space.
Fresno County is exploring possible alternative locations for its programs currently located on the Kings Canyon University Medical Center Campus. The Campus has been sold and the County has a few years to move to another location. Central Star will be expected to work with the County in relocation efforts of Adolescent PHF in the likely event that a different site is identified during the term of the contract. During the process of relocation, the recommended Facility Use Agreement will need to be amended to identify the change of location to the new premises.
Upon your Board’s approval, the recommended PHF Agreement and Facility Use Agreement will be effective July 1, 2020 through June 30, 2023, a three-year base contract with two optional one-year extensions through June 30, 2025. If sufficient funds are not allocated, the recommended Agreement allows for termination, at any time upon giving the Contractor thirty days advanced written notice. In addition, the recommended PHF Agreement allows the County or Contractor to terminate the contract without cause upon giving thirty (30) days advanced written notice to the other party of an intention to terminate.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of the recommended Agreement during the May 20, 2020 meeting.
REFERENCE MATERIAL:
BAI #31.1, April 28, 2020
BAI #17, February 2, 2016
BAI #32, June 2, 2015
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Central Star Behavioral Health, Inc.
On file with Clerk - Facility Use Agreement with Central Star Behavioral Health, Inc.
CAO ANALYST:
Ronald Alexander