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Approve a third contract amendment with Merced Behavioral Health, LLC for $993,000 for a total contract amount of $2,068,300 to provide additional subacute psychiatric residential treatment for the current period through June 30, 2025; 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 third contract amendment with Merced Behavioral Health, LLC for $993,000 for a total contract amount of $2,068,300 to provide additional subacute psychiatric residential treatment for the current period through June 30, 2025, 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:
Merced Behavorial Health, LLC is a long-term locked mental health treatment program that provides intensive services to support the ongoing needs of high acuity subacute clients, including 24-hour mental health nursing care, personalized treatment plans, structured living environments, mental health education, medication management, residential care treatment, and regular progress evaluations with a psychiatrist and an interdisciplinary treatment team. Individuals placed in Merced Behavioral Health cannot be stabilized in an acute inpatient setting and require a longer period of time in a locked setting for their own safety or the safety of others. This third contract amendment reflects the recent placement of seven (7) additional clients, bringing the total to eleven (11) beds for Solano County Behavioral Health clients.
FINANCIAL IMPACT:
The contract with Merced Behavioral Health is funded with 1991 Realignment revenue. Appropriations for the amendment are included in the Department’s FY2023/24 Working Budget. No additional County General Fund is being requested for this amendment.
DISCUSSION:
During the last year, Solano County Behavioral Health has seen an increase in the complex psychiatric and specialized treatment needs of Solano County Behavioral Health clients, necessitating a higher level of care in locked settings. Locked Specialized Treatment Programs (STPs) and Institutions for Mental Disorders (IMDs) are used when a client is psychiatrically evaluated to be 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 to achieve the goal of alleviating the symptoms of grave disability, improving functional impairment, and increasing independence through recovery-based treatment. Obtaining an available STP and IMD bed has become a greater challenge each year as overall demand has increased, but the number of available IMD beds across the State has not kept pace with the growing need for this specialized treatment. These limited resources are further reduced for those clients with co-occurring complex psychiatric and medical conditions. Merced Behavioral Health, LLC has demonstrated the ability to provide this specialized level of care to meet the psychiatric and specialized treatment needs of Solano County Behavioral Health clients.
On June 27, 2023, the Board approved the original contract with Merced Behavioral Health for $826,724 for the period of July 1, 2023 through June 30, 2025. On February 6, 2024, the Board approved the first amendment to increase the contract by $248,576 which was necessary at that time for the continued care of clients placed in this facility as the cost of services was on pace to exceed the original contract amount. The current cost of services in this treatment setting is $226.39 per client per day. The second contract amendment was executed in April 2024 and reflects a new daily bed rate of $237.70 per day, effective July 1, 2024.
This third contract amendment reflects the recent placement of seven (7) additional clients, bringing the total to eleven (11) beds for Solano County Behavioral Health clients. The current cost of services is on pace to exceed the present amount by $993,000 before the contract term end of June 30, 2025. The recommended amendment will provide for approximately 5,280 additional bed days.
ALTERNATIVES:
The Board could choose not to approve this contract amendment. This is not recommended as it would limit the available locked specialized treatment programs for Behavioral Health clients with subacute and complex psychiatric needs and would result in having to move up to eleven (11) clients currently receiving treatment for chronic grave disability.
OTHER AGENCY INVOLVEMENT:
None.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION