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Approve a first amendment to the agreement with Caminar Inc. for $734,514 to provide comprehensive case management, for a total contract amount of $2,130,514 through June 30, 2020; and Authorize the County Administrator to execute the amendment and any subsequent amendments that remain within budgeted appropriations
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board approve a first amendment to the agreement with Caminar Inc. for $734,514 to provide comprehensive case management, for a total contract amount of $2,130,514 through June 30, 2020; and Authorize the County Administrator to execute the amendment and any subsequent amendments that remain within budgeted appropriations.
SUMMARY:
Caminar Inc., currently provides comprehensive case management (CCM) services to an active caseload of 120 seriously and persistently mentally ill (SMI) beneficiaries with mental health and co-occurring disorders who are living in the community (apartment, board and care home, hotel, etc.) and are referred to this level of care by the Solano County treatment team. The requested amendment will increase the active caseload by 50%, to serve a total of 180 beneficiaries. The current caseload and needs of the community require increasing the number of individuals served within this program. This amendment also expands the types of services provided and allows for more flexibility to provide services more frequently when clinically necessary.
FINANCIAL IMPACT:
Short Doyle Medi-Cal and 1991 Realignment provide funding for this agreement. Appropriation is available in the Department’s FY2018/19 Adopted Budget and is included in the Department’s FY2019/20 Recommended Budget. The costs associated with preparing the agenda item are nominal and absorbed by the department’s FY2018/19 Adopted Budget. There is no additional financial impact to the County General Fund.
DISCUSSION:
On June 26, 2018, the Solano County Board of Supervisors approved Health & Social Services request to renew the contract with Caminar Inc. for Comprehensive Case Management (CCM); Item 18-392, Contract #03517 on the list of Master List contracts.
The CCM program is an integral part of the adult behavioral healthcare system, currently serving an active caseload of 120 seriously mentally ill beneficiaries who are at high risk of hospitalization and homelessness. These individuals are often stepping down from a higher level of care and require continued support and intervention to maintain treatment gains and continue their recovery. Caminar Inc. currently provides two to four services per month to each beneficiary, including skills building, housing support and psychiatric rehabilitation to help these beneficiaries increase independence and decrease risk of hospitalizations.
The proposed amendment is an expansion of this program and will fund staffing for increased scope and breadth of services and increased capacity to serve more individuals. The expanded program will provide additional and more frequent services, including increased peer support staff and a co-occurring specialist. The expanded program will serve an active caseload of 180 consumers, with three to five services per month, and occasionally more frequently if needed for a brief period of time. This change to the program provides increased flexibility and responsivity to the increasing demand for intensive case management services for Solano beneficiaries. It enables the program to maintain continuity of care when service needs increase rather than transferring to another more intensive service program when the intensive service need may be for a short duration and best handled within the existing treatment relationship.
Lastly, the proposed contract amendment allows Caminar to increase salaries to be consistent with industry and local standards and improve staff retention which is critical to maintaining continuity of care for Solano County beneficiaries within the program. Salary adjustments are intended to prevent the disruptions of care that occur with staff turnover and the negative fiscal impacts of recruitment and training new staff, and the lack of billable service activity that occurs during vacancies.
ALTERNATIVES:
The Board may choose not to approve the contract amendment for Caminar Inc. comprehensive case management. This is not recommended as it could result in failure to meet mandated requirements and risks individuals requiring inpatient psychiatric hospitalization. CCM provides services to clients who otherwise would require a higher level of care and is a critical program in the continuum of services to adults with severe mental illness.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the original contract for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION