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Approve three Health and Social Services, Behavioral Health Division contract amendments to provide additional acute psychiatric inpatient services for the current period through June 30, 2025: a first contract amendment with Fremont Hospital for $258,384 for a total contract amount of $910,014, a second contract amendment with Heritage Oaks Hospital for $425,286 for a total contract amount of $821,582, and a third contract amendment with San Jose Behavioral Health for $554,041 for a total contract amount of $1,200,920; and Delegate authority to the County Administrator to execute the three amendments and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999
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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, Behavioral Health Division recommends that the Board of Supervisors approve three contract amendments to provide additional acute psychiatric inpatient services for the current period through June 30, 2025: a first contract amendment with Fremont Hospital for $258,384 for a total contract amount of $910,014, a second contract amendment with Heritage Oaks Hospital for $425,286 for a total contract amount of $821,582, and a third contract amendment with San Jose Behavioral Health for $554,041 for a total contract amount of $1,200,920; and delegate authority to the County Administrator to execute these amendments and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999.
SUMMARY:
The three contractors provide acute psychiatric inpatient treatment services for Solano County Medi-Cal beneficiaries or indigent clients who are referred by Solano County Behavioral Health. Over the last few months there has been an increase in referrals/admissions to the three facilities. The contract amendments will provide for the continuation and medical services that are recognized and accepted for the diagnosis and treatment of behavioral health disorders or psychological injuries.
FINANCIAL IMPACT:
The three contract amendments will be funded with 1991 Realignment, 2011 Realignment, and County General Fund. Appropriations for the amendments are included in the Department’s FY2024/25 Working Budget. No additional County General Fund is being requested for these amendments.
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 suffering from acute psychiatric issues. Clients 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 an inpatient psychiatric hospital bed remains a challenge as overall demand continues to increase and outpace the number of available beds across the State. Additionally, current County placement numbers are exceeding projections and bed rates have increased. The recommended contract amendments will provide: 116 bed days at Fremont Hospital, 324 at Heritage Oaks Hospital, and 230 at San Jose Behavioral Health through June 30, 2025.
On June 27, 2023, the Board approved the Fremont Hospital contract for $651,630, Heritage Oaks Hospital contract for $316,856, and San Jose Behavioral Health contract for $507,215, all three for the term of July 1, 2023 through June 30, 2025. The first contract amendment with Heritage Oaks Hospital, approved by the Board on November 12, 2024, increased the contract by $79,440. The first contract amendment with San Jose Behavioral Health, amended on December 1, 2023, reflected bed rate increases and had no impact on total contract amount. The second contract amendment, approved by the Board on November 12, 2024, adjusted rates and increased the contract by $139,664.
ALTERNATIVES:
The Board may choose not to approve these contract amendments. 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. These amendments will ensure continued acute inpatient psychiatric services are provided to these clients.
OTHER AGENCY INVOLVEMENT:
None.
APPROVE DEPARTMENTAL RECOMMENDATION