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Approve a sixth contract amendment with Psynergy Programs, Inc. for $880,000 for a total contract amount of $4,270,254 to provide additional subacute inpatient residential psychiatric medical services for the current period through June 30, 2025; and Delegate authority to the County Administrator to execute the contract 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 sixth contract amendment with Psynergy Programs, Inc. for $880,000 for a total contract amount of $4,270,254 to provide additional subacute inpatient residential psychiatric medical services for the current period through June 30, 2025; and delegate authority to the County Administrator to execute the contract amendment and any subsequent amendments, with County Counsel concurrence, up to an aggregate of $74,999.
SUMMARY:
Psynergy Programs, Inc. is an augmented board and care facility, which is a ‘step-down’ from a long-term locked facility and provides a higher level of care than a board and care or independent living environment to consumers with severe and persistent mental illness. The program’s primary goal is to assist and support consumers in obtaining the necessary skills to transition to a less restrictive independent living environment. Psynergy Programs provides case management, medication management and monitoring, individual and group therapy, and crisis intervention.
There is an increased need for behavioral health resources for Solano County Behavioral Health clients and a growing demand for limited treatment programs throughout the State of California. This amendment will support medically necessary care for high-acuity clients with complex psychiatric needs with goal of ameliorating symptoms of chronic grave disability, increasing independence, and supporting recovery-oriented treatment goals. The requested increase will provide approximately 3,050 additional bed days for Solano County Behavioral Health clients for the remainder of the contract period.
FINANCIAL IMPACT:
This sixth contract amendment is funded with 1991 Realignment and Medi-Cal revenues. Appropriations are available in the FY2024/25 Working Budget. There is no impact to the County General Fund.
DISCUSSION:
Augmented Board and Care (ABC) treatment facilities are used when a client is psychiatrically evaluated to be severely mentally ill with limited capacity to meet their basic needs without twenty-four hours a day, seven days a week residential treatment for the psychiatric condition. An ABC is an unlocked setting with delayed egress. Many clients requiring an ABC are chronically gravely disabled and placed under a mental health conservatorship by an order of the court. The purpose of mental health conservatorships is to provide individualized treatment, supervision, and living arrangements for people who are seriously mentally ill while still protecting their rights. Mental health conservatorships, often referred to as LPS conservatorships because the Lanterman-Petris-Short Act governs them, can involve confinement in a locked psychiatric facility or placement in an ABC to achieve the goal of alleviating the symptoms of grave disability, improving functional impairment, and increasing independence through recovery-based treatment.
Obtaining available ABC beds has become increasingly challenging each year as overall demand grows, yet the number of ABC beds across the State has not kept pace with the current treatment market. Psynergy Programs, Inc. 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 July 25, 2023, the Board approved the original contract with Psynergy Programs, Inc. for $2,090,254 for the period of July 1, 2023 through June 30, 2025. The first, second, third, and fourth amendments modified the contract's budget and updated billing rates without changing the total contract amount. The fifth contract amendment, approved by the Board on October 2, 2024, increased the contract by $1,300,000 as the number of clients requiring this level of specialized care grew from 13 to 20. The number of clients requiring this level of specialized care has now grown to 25. Depending on the acuity level, the cost of treatment in this setting ranges from $177.61 to $293.98 per day. This amendment will allow for the continued care of clients placed at this specialized treatment program and additional placements if needed.
ALTERNATIVES:
The Board may choose not to approve this contract amendment. This is not recommended as this limits the available ABC facilities for Solano County Behavioral Health clients with high-acuity psychiatric needs, many of whom are LPS conserved, and would result in having to relocate several clients prematurely, thus disrupting their treatment program before reaching their behavioral health treatment goals.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION