DATE: December 11, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Agreement with Kings View Behavioral Health for Fresno Metropolitan Crisis Intervention Team Mental Health Services
RECOMMENDED ACTION:
TITLE
Approve and authorize the Chairman to execute an Agreement with Kings View Behavioral Health for the provision of Crisis Intervention Team Mental Health Services within the Fresno Metropolitan area, effective December 11, 2018 through June 30, 2023, which includes a 2.5 year base contract and two optional one-year extensions, total not to exceed $11,223,306.
REPORT
Approval of the recommended action will allow Kings View Behavioral Health to provide Crisis Intervention Team (CIT) Services to individuals experiencing an acute mental health crisis in the Fresno Metro area utilizing a co-response model with law enforcement agencies. The CIT services are fully funded by Federal Financial Participation (FFP) Medi-Cal revenue, and Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) funds with no increase in Net County cost.
ALTERNATIVE ACTION:
There is no viable alternative action. Should your Board not approve the recommended action, individuals in the Fresno Metro area of the county who are actively experiencing a mental health crisis will be subject to the negative consequences of inadequate access to appropriate crisis intervention services. The unserved targeted individuals would continue to utilize the existing emergency first responder and more costly emergency crisis services. This population suffers with episodes of mental illness and will continue the cycle from episode to crisis services, to the justice system and/or crisis hospitalization, to home without the benefit of mental health CIT services to prevent, de-escalate, intervene, and/or redirect and link said individuals to more appropriate and effective mental health treatment services.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The maximum compensation of the agreement is $11,223,306 and will be fully funded by Federal Financial Participation (FFP) Medi-Cal revenue, and Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) funds. Sufficient appropriations and estimated revenues are included in DBH’s Org 5630 FY 2018-19 Adopted Budget and will be requested in subsequent fiscal year budgets for the duration of the contract term.
DISCUSSION:
DBH initiated a pilot program in 2017 with crisis intervention field clinicians providing co-response and co-location with Fresno Police Department officers dedicated to responding to crisis calls. Evaluation of the initial phase of the pilot indicated that the need for this type of CIT services is far greater. On July 3, 2018, DBH through County Purchasing released Request for Proposal (RFP) No. 18-059. The RFP notice was sent to sixty-seven (67) companies and was posted on Purchasing’s Public Purchase site. County Purchasing received one proposal by the closing date, August 8, 2018. Pursuant to direction from County Purchasing, DBH proceeded with contract negotiations with Kings View Behavioral Health to provide Fresno Metro CIT Mental Health Services. Crisis intervention services will be provided by the CIT Team, comprised of clinical staff who are co-located and will co-respond with law enforcement agency officers to the location where individual are currently suffering a mental illness episode. The CIT team creates an environment where triage services are most effective, beneficial, and necessary. The CIT services provided include, but are not limited to:
• intervention and de-escalation;
• prevention and education;
• mental health crisis triage;
• referrals and linkage to appropriately identified community resources; and,
• concise case management and follow-up, as appropriate.
The CIT program is also designed to include outreach and education for emergency first responders, mental health clients, and the community at large.
DBH anticipates that with the approval of the recommended agreement, emergency calls and more costly emergency crisis services related to mental health episodes in the community will decrease after the first year of the Fresno Metro CIT services.
Performance measures and outcomes will be collected throughout the term of the recommended agreement to determine program success and sustainability. The Metro CIT program will be evaluated for effectiveness with regards to wellness and recovery, reduction in the use of expensive crisis services, emergency calls, emergency department visits, and improved access to care for mental illness and suicide prevention.
The recommended agreement contains contract language to allow the DBH Director, or designee, to terminate without cause with 60 days advance written notice and to authorize budget line item changes, that do not exceed ten percent (10%) of the total annual budgeted amount, based on service need with approval of the DBH Director, or designee, without an increase to the annual contract maximum compensation.
With your Board’s approval, Fresno Metro CIT Services will begin upon contract execution for a 2.5-year term ending June 30, 2021. The recommended agreement may be extended for two additional consecutive 12-month periods upon written approval of both parties no later than 60 days prior to the close of the contract term. The DBH Director, or designee, is authorized to provide such written approval on behalf of the Contractor’s satisfactory performance and available funding.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended agreement at its June 20, 2018 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement
CAO ANALYST:
Ronald W. Alexander, Jr.