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Approve a contract amendment with Crestwood Behavioral Health, Inc. in the amount of $700,000 for a total contract amount of $2,449,236 to provide sub-acute psychiatric residential treatment for seriously/persistently mentally ill patients for the term July 1, 2012 through June 30, 2013; and Authorize the County Administrator to sign the contract amendment
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board approve a contract amendment with Crestwood Behavioral Health, Inc. in the amount of $700,000 for a total contract amount of $2,449,236 to provide sub-acute psychiatric residential treatment for seriously/persistently mentally ill patients for the term July 1, 2012 through June 30, 2013 and authorize the County Administrator to sign the contract amendment.
SUMMARY:
Solano County Mental Health provides a continuum of mental health services to approximately 5,500 mental health consumers in Solano County through County provided services and 83 contracts with community providers. Crestwood Behavioral Health provides a full range of psychiatric rehabilitation services and treatment activities to consumers, particularly as a step-down system for individuals who would otherwise remain in a costly inpatient facility. At any one time, individuals requiring this intensive level of support number between 30 and 50. Individuals placed at one of the Crestwood facilities are stabilized psychiatrically until they can be reintegrated into the community or a lower level of care in the community. Due to the Department's intensification of its efforts to decrease utilization and lengths of stay at more costly State Hospitals and other acute inpatient facilities which typically cost four to five times the amount of the Crestwood placements, it is being requested to increase the contract with Crestwood to accommodate the increase need for its level of service.
FINANCIAL IMPACT:
The total amount of the contract for FY2012/13 will be $2,449,236 with the approval of this $700,000 amendment. The funding for these services comes from budgeted Realignment with no impact to the County General Fund.
DISCUSSION:
Crestwood Behavioral Health, Inc. provides a full range of psychiatric rehabilitation services and treatment activities for Solano County clients. Activities include, but are not limited to: psychological assessment, symptom management training, Activities of Daily Living training, group treatment, social skills, vocational readiness training, medication monitoring and management, and wellness and recovery activities. These activities promote stabilization of mental health disorders with the goal of reintegrating clients into the community. Most of the Solano County clients served by Crestwood are individuals who have been conserved through Lanterman-Petris-Short Act court proceedings and require temporary placement in a locked facility. These services are mandated by law pursuant to Solano County's contract with the State Department of Health Care Services.
H&SS opened the Crisis Stabilization Unit with the ultimate goal of decreasing costly and lengthy hospital stays, particularly at Napa State and Metropolitan State hospitals. Additionally, efforts have been intensified to bring individuals out of costly acute care facilities more quickly as clinically indicated through intensive case management. This change in policy was predicated on two ideas, one to ensure that clients are provided services in the lowest level needed to assist with integration back into the community; and two, to reduce the costs associated with placing clients in higher level settings.
Consequently, the need to place clients in sub-acute facilities has increased. The Department is actively seeking other sub-acute facilities to utilize and to continue the positive trend of diverting away from extended State and other inpatient hospital stays. It remains the focus of H&SS to place the care of the client as its top priority while also reducing County costs to maintain sustainable services.
ALTERNATIVES:
The Board may choose to not approve the contract amendment. This is not recommended because it would limit services for mentally ill adults in Solano County, resulting in increases in hospitalizations, homelessness, and incarceration. Without these placements and service options clients could also end up in inappropriate levels of care that are more costly such as private and State inpatient hospitals, which are County-funded.
OTHER AGENCY INVOLVEMENT:
County Counsel has approved the contract amendment as to form.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION