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Approve a second contract amendment with Ever Well Health Systems, LLC for $100,000 for a total contract amount of $1,990,000 to provide residential treatment for high acuity clients with complex psychiatric needs in an augmented board and care treatment facility setting for the current period through June 30, 2024; and Delegate authority to the County Administrator to execute the amendment 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 recommends that the Board of Supervisors approve a second contract amendment with Ever Well Health Systems, LLC for $100,000 for a total contract amount of $1,990,000 to provide residential treatment for high acuity clients with complex psychiatric needs in an augmented board and care treatment facility setting for the current period through June 30, 2024; and delegate authority to the County Administrator to execute the amendment and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999.
SUMMARY/DISCUSSION:
On June 28, 2022, the Board approved a contract with Ever Well Health Systems, LLC for $1,600,000 for the period of July 1, 2022 through June 30, 2024 to provide intensive psychiatric residential treatment services for high-acuity care clients, including case management, individual and group therapy, crisis intervention, and medication management and monitoring. Ever Well Health Systems, LLC operates multiple residential treatment facilities in Northern and Central California for individuals with severe and persistent mental illness in an augmented board and care (ABC) setting. An ABC is an unlocked setting used when a client is psychiatrically evaluated to be unable to meet their primary care needs without 24/7 residential treatment for their mental illness. Many clients requiring an ABC are chronically gravely disabled and placed under a mental health conservatorship by order of the court to provide individualized treatment, supervision, and living arrangements while still protecting their rights. Mental health conservatorships, often called LPS conservatorships because the Lanterman-Petris-Short Act governs them, can involve confinement in a locked psychiatric facility or placement in an ABC.
Solano County Behavioral Health regularly uses Ever Well Health Systems’ residential treatment programs to place high-acuity clients needing the highest level of care outside of a locked facility. Obtaining an available ABC bed has become a more significant challenge each year as overall demand has increased, yet the number of ABC beds across the State of California has not kept pace with the current treatment market. Since 2021, Solano County Behavioral Health has experienced a 38% increase in LPS-conserved clients, and additional ABC beds are needed for Solano County clients.
Ever Well Health Systems has demonstrated the ability to provide this specialized level of care to meet the psychiatric needs of Solano County Behavioral Health’s most vulnerable clients. On May 7, 2024, the Board approved a first contract amendment, increasing the contract by $290,000 for a new total amount of $1,890,000 due to an increase in LPS-conserved clients and the need for additional ABC beds for Solano County clients.
This second amendment is necessary for the continued care of current clients in this specialized treatment program as placements have increased from 11 to 14 individuals and the cost of services is on pace to exceed the current contract amount prior to contract expiration on June 30, 2024. The recommended contract increase will provide for approximately 612 additional bed days (which range in cost from $117 to $262 per day) for the remainder of the contract, allowing for the continued care of current clients in this specialized treatment program.
FINANCIAL IMPACT:
Appropriations are available in the FY2023/24 Working Budget to cover the increase of $100,000 which will be funded with 1991 Realignment. There is no impact to the County General Fund.
ALTERNATIVES:
The Board could choose not to approve this contract amendment. This is not recommended as this limits the available augmented board and care facilities for Behavioral Health clients with high acuity psychiatric needs, many of whom are LPS conserved, and would result in having to move up to 14 clients prematurely, thus disrupting their treatment program prior to reaching their behavioral health treatment goals.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION