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Approve a second contract amendment of $83,750 to the agreement with Davis Guest Home to increase the total contract amount from $970,000 to $1,053,750, funded through 1991 Realignment and County General Fund, for augmented board and care psychiatric medical services through June 30, 2017; and Authorize the County Administrator to execute the 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 second contract amendment to the agreement with Davis Guest Home to increase the total contract amount from $970,000 to $1,053,750, funded through 1991 Realignment and County General Fund, for augmented board and care psychiatric medical services through June 30, 2017; and Authorize the County Administrator to execute the amendment.
SUMMARY:
The original contract with Davis Guest Home for $614,000 was approved on June 23, 2015. Due to continued demand for augmented board and care housing, the contract was amended by $356,000 for a revised contract total of $970,000 on November 8, 2016. The demand for services provided by Davis Guest Home for County Behavioral Health Consumers has continued to exceed anticipated levels during the latter portion of FY2016/17. The requested amendment of $83,750 for a revised total contract of $1,053,750 will allow for the continuation of services and housing for 17 individuals through June 30, 2017.
FINANCIAL IMPACT:
Funding for this amendment is provided with 1991 Realignment and County General Fund and appropriation is available in the Department’s FY2016/17 Budget. There is no additional financial impact to the County General Fund.
DISCUSSION:
Davis Guest Home is an augmented board and care facility which provides residential treatment for individuals who are disabled and are often under Public Guardian conservatorship. Behavioral Health must provide for needed services to individuals conserved under Lanterman-Petris-Short (LPS) Act since they are not able to care for themselves and often require a higher level of structured residential care. These services include daily mental health services and support for improved functioning and individualized preparation to develop the skills necessary to move to a basic board and care or other community based housing arrangement.
H&SS has been successful in facilitating appropriate treatment options when transitioning clients who are ready from costlier, locked mental health care facilities to lower level care facilities such as Davis Guest Home. The move to a less restrictive housing allows for gradual exposure to community living, an important step as clients begin to learn to independently care for themselves.
While there has typically been an average of 12 to 14 clients at Davis Guest Home at an average daily rate of $98, the census is currently 17 individuals. Last year 5 individuals discharged from the facility, but this fiscal year only 2 have discharged. This is due to a combination of the severity of the clients’ mental health condition and a shortage of supportive board and care facilities or room and boards available in the County for clients to move to when ready. There is one client who is ready to leave once a board and care placement becomes available. County staff work closely with the facility staff to prepare clients for a lower level of care. The length of stay at Davis Guest Home ranges from 6 months to over 6 years, with the current average length of stay at 3 years. Two individuals have been there for longer than six years and are not anticipated to step down to the community in the near future due to the continued severity of symptoms and impairment of functioning. Clients who are placed at Davis Guest Home have a more protracted history of mental health impairment and require longer periods of time to recover enough to be successful in a less structured environment. Forty percent of the clients at this facility are over the age of 50.
ALTERNATIVES:
The Board may choose not to approve the contract amendment for Davis Guest Home. This is not recommended as the County is required to have psychiatric services for clients served in the County mental health system and this amendment will ensure continued housing and supportive services to meet these clients’ needs. Without this contract amendment, several clients would need to be discharged without a suitable place to go.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the contract for legal sufficiency. Public Guardian works closely with several of the clients placed at this facility.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION