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Approve a second contract amendment with Fremont Hospital for $200,000 for a total contract amount of $1,110,014, for the provision of acute psychiatric inpatient services during the contract period ending June 30, 2025
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Published Notice Required? Yes ___ No X _
Public Hearing Required? Yes ___ No X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health and Social Services (H&SS) recommends that the Board of Supervisors approve a second contract amendment with Fremont Hospital for $200,000 for a total contract amount of $1,110,014, for the provision of acute psychiatric inpatient services during the contract period ending June 30, 2025.
SUMMARY:
Fremont Hospital provides acute psychiatric treatment services for Solano County Medi-Cal beneficiaries or indigent clients referred by Solano County Behavioral Health or local emergency departments. During the final months of the FY2024/25 contract period, the volume and duration of client placements collectively exceeded the contract amount. Due to the emergent nature of psychiatric crises, the number and length of placements cannot be fully anticipated or planned for in advance. This amendment provides funding for the delivery of medically necessary services for the diagnosis and treatment of behavioral health disorders and psychological conditions through June 30, 2025.
FINANCIAL IMPACT:
The contract amendment will be funded with 1991 Realignment or 2011 Realignment depending on the client’s Medi-Cal status. As this amount was not expected for FY2024/25, FY2025/26 budgeted appropriations will be used for this amendment. During the FY2025/26 Mid-Year Budget process, Health and Social Services will assess the impact of this amendment on current year appropriations and will adjust appropriations at that time if needed. There is no impact on the County General Fund.
DISCUSSION:
Locked inpatient psychiatric hospitals are essential in providing a structured, therapeutic clinical environment to effectively and rapidly treat children, adolescents, adults, and older adults’ acute psychiatric issues. Clients placed receive an initial assessment, diagnosis, and rapid stabilization of acute psychiatric and co-occurring disorders (psychiatric and substance abuse disorders) with intensive physician involvement and oversight, a physician-led multidisciplinary treatment team, an individualized client treatment plan, therapeutic groups, educational classes, and comprehensive care coordination and discharge planning, including a smooth transition to less intensive, appropriate levels of follow-up care and support.
Obtaining inpatient psychiatric hospital beds remains a persistent challenge as demand for these services continues to rise. Placement numbers continue to exceed projections, and bed rates have increased.
On June 27, 2023, the Board approved the original Fremont Hospital contract for $651,630 for the term of July 1, 2023, through June 30, 2025. On March 25, 2025, the Board approved a first amendment to the agreement and increased the contract amount by $258,384 for an additional 116 bed days. The recommended second contract amendment increased the contract by an additional $200,000 to provide an additional 90 bed days to clients by Fremont Hospital through June 30, 2025 based on the census as of that date.
ALTERNATIVES:
The Board may choose not to approve this second contract amendment with Fremont Hospital. This is not recommended as the County is mandated to provide psychiatric services for clients in the County mental health system who need mental health care for their own safety and the safety of the community.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the contract for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION