DATE: July 11, 2017
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment I to Master Agreement with Rate Classification Level 12-14 Group Homes for Specialized Residential Mental Health Services
RECOMMENDED ACTION:
TITLE
Approve and authorize the Chairman to execute a retroactive Amendment I to Master Agreement No. 14-313 with Rate Classification Level 12, 13, 14 Group Homes for mental health treatment services to seriously emotionally disturbed children, effective July 1, 2017 extending the term to June 30, 2019 and increasing the maximum by $1,800,000 to a total of $4,500,000.
REPORT
Approval of the recommended action will allow the Department to continue specialized residential mental health services for seriously emotionally disturbed (SED) youth, ages six to 18, requiring elevated levels of care. The recommended amendment will extend the term two additional years contingent upon satisfactory performance, as specified in the agreement. Expenditures will not exceed $900,000 per fiscal year, with no increase in Net County Cost.
ALTERNATIVE ACTION(S):
There is no viable alternative action. If the recommended action is not approved, County high-risk SED youths medically appropriate for Rate Classification Level (RCL) 12-14 group homes will not receive the appropriate level of care and may result in repeated crisis visits, inpatient hospitalization, and other safety risks.
RETROACTIVE AGREEMENT:
The proposed agreement is retroactive to July 1, 2017, to ensure all expenses for clients who have been referred and served by the providers on this contract are compensated timely.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The annual compensation will remain at $900,000. The maximum compensation will increase 60% ($1,800,000) from $2,700,000 to $4,500,000. Contracted mental health treatment services will be financed by Medi-Cal Federal Financial Participation (50%), Behavioral Health Realignment (40%), and Mental Health Realignment (10%). Sufficient appropriations are included in the Department’s Org. 5630 FY 2017-18 Recommended Budget. Actual costs will be based on actual services provided.
DISCUSSION:
Throughout California, there is a limited number of high level of care facilities and beds for SED children ages six to 18. Many residential treatment programs are certified and designed to serve severely emotionally and behaviorally disturbed children ages 12 to 18. The SED behavior may present a potential danger to self, others, or property. Treatment often requires planned psychiatric evaluation, close supervision and monitoring concerning the need for psychopharmacological intervention.
On June 10, 2014, your Board approved Master Agreement No. 14-313 with specialized residential mental health service providers to treat SED children ages six to 18. The children are court dependents or adjudicated from the juvenile justice or dependents of the court placed in medically appropriate for RCL 12-14 group homes. The recommended amendment will address the Department’s continued need for additional resources for SED children who require a higher level of placement.
RCL 12-14 group homes provide the highest level of care in the outpatient setting, outside of a locked facility. The educational component is funded through school districts. The residential board and care component is funded through either the Department of Social Services or the Probation Department. The mental health services component is funded through mental health Medi-Cal claiming by the Department of Behavioral Health and includes intensive full-day treatment, individual and group therapies and rehabilitation, medication support, crisis intervention, and case management.
With your Board’s approval, the recommended amendment will extend the agreement for two one-year terms, for a total of five years. The agreement contains language, which includes the provision to allow the Director, or designee, to terminate without cause with 30-day advanced written notice and to approve the addition and/or deletion of qualified providers as funding permits.
OTHER REVIEWING AGENCIES:
The Fresno County Behavioral Health Board was informed of the recommended amendment at the June 14, 2017 meeting.
REFERENCE MATERIAL:
BAI #17, June 10, 2014 - Master Agreement No. 14-313
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Master Agreement No. 14-313 with Rate Classification Level 12-14 Group Homes
CAO ANALYST:
Sonia De La Rosa