DATE: August 24, 2021
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Amendment to Master Agreement with Licensed Residential Care Facilities
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute retroactive Amendment I to Master Agreement No. 17-377 with various licensed residential care facilities to provide supplemental board and care home services to persistently and severely mentally ill adult and older adult individuals, effective March 1, 2021 with no change in term of July 1, 2017 through June 30, 2022 and increasing the maximum by $3,775,000 to a total of $28,775,000.
REPORT
Approval of the recommended action will update contract language to allow the Director of the Department of Behavioral Health to approve higher level of specialized supplemental board and care home services. Increased Substance Abuse and Mental Health Services Agency Community Mental Health Services Block Grant and Mental Health Realignment funding will place individuals within licensed residential care facilities, with no increase in Net County Cost. This item is countywide.
RETROACTIVE AGREEMENT:
The proposed amendment is retroactive to March 1, 2021 to pay outstanding expenses rendered during FY 2020-21. The number of individuals in need of the services delivered under the agreement during FY 2020-21 were beyond those projected prior to the COVID-19 pandemic. The delay in bringing the amendment to your Board was due to due to some contractors invoicing late, which delayed review and reconciliation by the Department.
ALTERNATIVE ACTION(S):
Should your Board not approve of the recommended action, the Department would be unable to reimburse contractors for services rendered during FY 2020-21 and reduce the Department’s capacity to place individuals within local licensed residential care facilities in FY 2021-22.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended amendment will be financed with Substance Abuse and Mental Health Services Agency Community Mental Health Services Block Grant and Mental Health Realignment funds. The maximum compensation will increase by $3,775,000 to $28,775,000. The increase is based on usage increases during FY 2020-21 and anticipated usage for FY 2021-22; the updated annual maximums will be $6,275,000 for FY 2020-21 and $7,500,000 for FY 2021-22 respectively. The outstanding estimated expenses rendered during FY 2020-21 total is $1,150,000. Sufficient appropriations and estimated revenues are included in the Department’s Org 5630 FY 2021-22 Recommended Budget. Total expenditures will be based on actual length of stay in the licensed facilities.
DISCUSSION:
On July 11, 2017, your Board approved Master Agreement No. 17-377 for supplemental board and care home services to adults who are persistently and seriously mentally ill and have specialized needs that require services not typically offered in standard board and care homes.
The recommended amendment adds language to the agreement which allows the Department Director, or designee, to approve another higher level of specialized supplemental board and care home services at an additional cost for specific individuals with higher level needs that would otherwise require placement at facilities for higher levels of care such as State hospitals, Institutions of Mental Disease, Mental Health Rehabilitation Centers or Skilled Nursing Facilities.
The supplemental services include but are not limited to, reasonable access to required medical treatment, up-to-date psychopharmacology, bilingual/bicultural programming, transportation to needed off-site services, self-sufficiency skills, enhancement of independent living skills.
A majority of the higher level of care facilities are located outside the County.
REFERENCE MATERIAL:
BAI #38, July 11, 2017
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended amendment during the August 18, 2021 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment I to Master Agreement No. 17-377
CAO ANALYST:
Sonia M. De La Rosa