DATE: July 10, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Retroactive Amendment I to Agreement 15-317 with Kings View Behavioral Health for Rural Mental Health Triage Services.
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Retroactive Amendment I to Agreement 15-317 with Kings View Behavioral Health for the provision of Rural Mental Health Triage Services, to extend the contract term for an additional two years from July 1, 2018 to June 30, 2020, and increasing the maximum compensation by $5,145,001 to a total not to exceed of $12,181,639.
REPORT
Approval of the recommended action will allow for a contract term extension of the current three-year agreement for two additional years and provide Kings View Behavioral Health the ability to record, maintain, and manage their electronic health records via the Department of Behavioral Health’s (DBH) integrated mental health information system, known as Avatar. Avatar is utilized by DBH through an existing agreement between DBH and Netsmart Technologies. Kings View Behavioral Health will reimburse DBH for the cost of its users. The current agreement is within its final year with a June 30, 2018 expiration date.
ALTERNATIVE ACTION(S):
There is no viable alternative action. Should your Board not approve the recommended action, clients will not receive adequate rural mental health triage services due to program services expiring June 30, 2018. Additionally, the County will not benefit from an opportunity to provide greater consistency in client treatment by allowing Kings View Behavioral Health expanded access to DBH’s integrated mental health information system.
RETOACTIVE AGREEMENT:
The recommended amendment is retroactive to July 1, 2018. Negotiations regarding possible enhancements or modification to the current program model resulted in this item being delayed longer than expected.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation will increase by $2,541,238 for FY 2018-19 and $2,603,763 for FY 2019-20, a total increase of $5,145,001 to $12,181,639, and will be fully funded by the existing funding sources including Medi-Cal Federal Financial Participation and Mental Health Services Act funds (Prevention and Early Intervention). Sufficient appropriations and estimated revenues will be included in the Department’s Org 5630 FY 2018-19 Recommended Budget and future budget requests for the duration of the term.
DISCUSSION:
On July 14, 2015, your Board approved Agreement No. 15-317 with Kings View Behavioral Health (Kings View) to provide Rural Mental Health Triage Services (Rural Triage Services) in East and West Fresno County incorporated cities. Rural Triage Services includes, but is not limited to assessment, crisis intervention, community referrals and linkages, and short-term/brief case management. In addition, services also include community outreach, engagement, education, and prevention. Current Rural Triage Services are flexible to the needs of rural County areas, and when resources are available, also address unincorporated rural communities. Rural Triage Services were initially fully funded by Senate Bill (SB) 82: Investment in Mental Health Wellness Act of 2013 grant, Public Safety Realignment, Federal Financial Participation (FFP) Medi-Cal revenue, and Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) funds with no Net County Cost. The SB 82 and Public Safety funding specifically targets the unserved rural clients currently impacting emergency first responder and more costly emergency crisis services to access mental health treatment. Moving forward, Rural Triage Services will be fully funded by Federal Financial Participation (FFP) Medi-Cal revenue and Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) funds, with no Net County Cost.
Being a start-up project, DBH opted to move forward with the original contract absent boilerplate language allowing the agreement to be renewed after the third fiscal year upon satisfactory performance. DBH has evaluated and deemed it appropriate to extend the current agreement out for two more fiscal years making it consistent with other DBH agreements.
Kings View has requested greater access to DBH’s integrated mental health information system, referred to as Avatar, in order to record, maintain, and manage their electronic health records. Currently, Kings View maintains their health records on a manual paper chart system and their access to Avatar is limited to only billing purposes of their contracted agreements. As a DBH-contracted provider, Kings View’s program is part of the Fresno County Mental Health Plan. In providing greater access to Kings View, treatment information for clients who utilize both DBH and Kings View programs, or transfer between the two, will be kept in a central repository and help facilitate greater consistency in client treatment. These records will include client authorization forms, assessments, treatment plans, progress notes, as well as other documents approved by DBH.
Approval of the recommended action to agreement No. 15-317 will allow for a contract term extension period of program services for two years beyond the existing expiration date of June 30, 2018.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended amendment at its May 16, 2018 Board Meeting.
REFERENCE MATERIAL:
BAI #35, July 14, 2015
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Agt. No. 15-317
CAO ANALYST:
Ronald W. Alexander, Jr.