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Approve a first contract amendment with Sierra Vista Hospital for $272,180 for a total contract amount of $926,295 to provide acute psychiatric inpatient treatment services for the current period through June 30, 2026; and Delegate authority to the County Administrator to execute the amendment and any subsequent amendments, with County Counsel concurrence, up to a fiscal year 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 (H&SS) recommends that the Board of Supervisors:
1. Approve a first contract amendment with Sierra Vista Hospital for $272,180 for a total contract amount of $926,295 to provide acute psychiatric inpatient treatment services for the current period through June 30, 2026; and
2. Delegate authority to the County Administrator to execute the amendment and any subsequent amendments, with County Counsel concurrence, up to a fiscal year aggregate of $74,999.
SUMMARY:
Sierra Vista Hospital provides acute psychiatric inpatient services for Solano County Medi-Cal beneficiaries and indigent individuals referred by Solano County Behavioral Health or local emergency departments. The hospital provides assessment, diagnosis, and 24-hour secure inpatient psychiatric treatment for individuals experiencing acute mental health crises.
Due to the unpredictable and emergent nature of psychiatric emergencies, the volume and length of inpatient placements is difficult to reliably project. Individuals are typically admitted following placement on an involuntary hold pursuant to Welfare and Institutions Code section 5150, when an individual is determined to be a danger to self, a danger to others, or gravely disabled as a result of a mental health disorder. This contract amendment authorizes continued funding for the provision of medically necessary inpatient psychiatric services for the diagnosis and treatment of behavioral health conditions through June 30, 2026.
FINANCIAL IMPACT:
Funding for this amendment will be provided by 1991 and 2011 Realignment, as inpatient services provided by this facility are not Medi-Cal billable. Appropriations are available in the FY2025/26 Working Budget for this amendment. There is no additional impact on the County General Fund.
DISCUSSION:
Locked inpatient psychiatric hospitals provide essential, structured treatment for children, adolescents, adults, and older adults experiencing acute psychiatric symptoms. These facilities are a required component of the County’s behavioral health crisis continuum and are necessary to meet statutory obligations under Welfare and Institutions Code section 5150 to detain, assess, and treat individuals who are determined to be a danger to self, a danger to others, or gravely disabled due to a mental health disorder.
Services include rapid assessment, diagnosis, and stabilization of psychiatric and co-occurring disorders, intensive physician oversight, individualized treatment planning, therapeutic programming, and coordinated discharge planning to ensure continuity of care and safe transition back to the community. Access to locked inpatient psychiatric beds is critical to ensure timely placement during psychiatric emergencies, prevent prolonged emergency department boarding, and maintain compliance with state-mandated involuntary treatment requirements.
Demand for inpatient psychiatric beds continues to exceed available capacity, with County placement volumes exceeding projections and per-bed rates increasing. The recommended contract amendment is necessary to maintain and expand access to inpatient psychiatric services at Sierra Vista Hospital. The proposed increase will fund an additional 204 inpatient bed days for the remainder of the fiscal year.
On June 25, 2024, the Board approved the Sierra Vista Hospital contract for $654,115, effective July 1, 2024, for the period of July 1, 2024 through June 30, 2026.
ALTERNATIVES:
The Board may choose not to approve this first contract amendment with Sierra Vista Hospital. This is not recommended as the County is mandated to provide psychiatric inpatient services for clients in the County Behavioral Health Services Division who need mental health care for their own safety and the safety of the community.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION