Agenda

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Consent-Health & Human Services # 28.

Board of Supervisors

Adult & Aging

Meeting Date:	05/21/2019
Brief Title: Crestwood Behavioral Health IMD Amendment
From:	Karen Larsen, Director, Health and Human Services Agency
Staff Contact:	Sandra Sigrist, Adult and Aging Branch Director, Health and Human Services Agency, x8794
Supervisorial District Impact:

Subject

Approve sixth amendment to Agreement No, 14-133 with Crestwood Behavioral Health, Inc. to increase funding for 2018-19 in the amount of $600,000 and 2019-20 in the amount of $650,000 for a new contract maximum of $11,131,627 to provide Mental Health Services to seriously mentally ill adults for the period July 1, 2014 through June 30, 2020. (No general fund impact) (Larsen)

Recommended Action

Approve sixth amendment to Agreement No, 14-133 with Crestwood Behavioral Health, Inc. to increase funding for FY18-19 in the amount of $600,000 and FY19-20 in the amount of $650,000 for a new contract maximum of $11,131,627 to provide Mental Health Services to seriously mentally ill adults for the period July 1, 2014 through June 30, 2020.

Strategic Plan Goal(s)

Operational Excellence
Thriving Residents
Safe Communities

Reason for Recommended Action/Background

Crestwood Behavioral Health, Inc. operates long-term facilities for adult psychiatric consumers. Consumers are placed into various facilities depending on the level of care needed and the specialization of the facility. Many of our most fragile clients cannot be placed in lower levels of care because they need the clinical/nursing supports offered in long-term facilities for adult psychiatric consumers. Due to the needs of the consumers and the limited availability of inpatient psychiatric beds statewide, Yolo County contracts with all available inpatient psychiatric facilities in the surrounding area to ensure access to adequate bed space for our consumers. Crestwood Behavioral Health, Inc. is one of a handful of facilities that are willing to take these chronically seriously mentally ill patients.

Yolo County continues to experience a steady increase in services needed for the stabilization of seriously mentally ill adults and the cost of care for consumers for several reasons. Due to the Affordable Care Act, the County has increased responsibilities in terms of the newly insured, now comprising of approximately 25% of our population. In addition, due to the severity of the consumer’s mental health conditions there are corresponding needs for the higher level of care provided by Crestwood Behavioral Health, Inc. Lastly, the severity of some consumers’ mental health condition has necessitated longer stays. There is also a new law as of January 1, 2019 that says that jails may refer clients for Lanterman Petris Short (LPS) conservatorship consideration, which is starting to have an impact on the numbers of clients referred for LPS. For these reasons, there is a need to increase the contract amount for this provider.

Collaborations (including Board advisory groups and external partner agencies)

County Counsel has approved this Agreement as to form.

Competitive Bid Process

A Sole Source has been completed and approved by the Purchasing Manager.

Fiscal Impact

Fiscal Impact (Expenditure)
Fiscal impact (see budgetary detail below)
Total cost of recommended action:		$ 600,000
Amount budgeted for expenditure:		$ 600,000
Additional expenditure authority needed:		$
On-going commitment (annual cost):	$

Source of Funds for this Expenditure

$600,000

Explanation (Expenditure and/or Revenue)

Further explanation as needed:

No general funds are required by this action. These services will be funded by Mental Health Realignment funds. The amount of $1,250,000 is included in the HHSA adopted budget for FY18-19 and HHSA proposed budget for FY19-20.

The following is the breakdown of funding for this agreement.

Scope of Services	FY14-15 7/1/2014 – 6/30/2015	FY15-16 7/1/2015 – 6/30/2016	FY16-17 7/1/2016 – 6/30/2017	FY17-18 7/1/2017 – 6/30/2018	FY18-19 7/1/2018 – 6/30/2019	FY19-20 7/1/2019 – 6/30/2020	Total
Institution for Mental Disease	$1,175,451	$1,645,451	$1,625,451	$1,395,906	$1,778,615	$1,680,753	$9,301,627
Mental Health Services for SMI in Board and Care (Patch Only)	$300,000	$330,000	$300,000	$300,000	$300,000	$300,000	$1,830,000
Total	$1,475,451	$1,975,451	$1,925,451	$1,695,906	$2,078,615	$1,980,753	$11,131,627

Attachments
Att. A. Agreement

Form Review

Inbox	Reviewed By	Date
Financial Services	Tom Haynes	05/14/2019 01:48 PM
County Counsel	Hope Welton	05/14/2019 02:15 PM
Form Started By: Kimberly Mayfield		Started On: 04/02/2019 08:29 AM
Final Approval Date: 05/14/2019