title
Approve a 3 year contract with Crestwood Behavioral Health, Inc. for a total amount of $13,139,264 to provide 23-hour crisis stabilization services for the period of June 1, 2018 through June 30, 2021 funded through MHSA Community Services and Support funds; and Authorize the County Administrator to execute the contract and any subsequent amendments that remain within budget appropriations
body
Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends the Board approve a 3 year contract with Crestwood Behavioral Health, Inc. for $13,139,264 to provide 23-hour crisis stabilization services for the period of June 1, 2018 through June 30, 2021 funded through MHSA Community Services and Support funds; and Authorize the County Administrator to execute the contract and any subsequent amendments that remain within budget appropriations.
SUMMARY:
Since November 2012, Health and Social Services has operated a 23-hour Crisis Stabilization Unit (CSU) at 2101 Courage Drive, Fairfield. The CSU provides psychiatric crisis services to Solano County for individuals who are acutely suicidal, homicidal, or gravely disabled. As part of an ongoing effort to ensure the highest quality of services, the Behavioral Health Division engaged in a recent procurement process to identify a new CSU vendor. Crestwood Behavioral Health, Inc., (Crestwood) was selected to provide CSU services. The contract is effective June 1, 2018 through June 30, 2021 for a contract amount not to exceed $13,139,264. The implementation will assure a smooth transition between vendors, and Crestwood will have the month of June to hire and train staff for expected launch of service delivery on July 1, 2018.
DISCUSSION:
On September 27, 2016, H&SS' Behavioral Health Division completed the FY2016/17 Annual Update and MHSA Three-Year Integrated Program and Expenditure Plan for FY2017/20, following an extensive community planning process required by the Department of Healthcare Services (DHCS). The approved plan included provisions for a Crisis Stabilization Unit to provide crisis stabilization mental health services for consumers experiencing acute psychiatric symptoms. Crisis stabilization services reduce the likelihood of suicide, homicide and other poor outcomes, and ensure that appropriate interventions occur within the community before more costly and restrictive placements in a psychiatric facility occur.
On July 1, 2011, the Department issued a request for proposal (RFP) for a Crisis Stabilization Unit. ANKA Behavioral Health, Inc. was selected and began operating the CSU in October 2012. With the MHSA 2014 Annual Update, the Department selected another vendor to provide CSU services. On August 5, 2014, the Board of Supervisors approved a contract with Exodus Recovery Services to operate the CSU. Since its inception in 2012, the CSU has significantly improved services to the acutely mentally ill, assisting emergency departments and jails by reducing the inappropriate housing of individuals experiencing a mental health crisis in a medical or jail setting while awaiting transfer to a 72-hour facility. Similarly, the operation of the CSU provides a centralized site for individual evaluations pursuant to State law and reduces the wait time formerly spent by law enforcement with clients in hospital emergency rooms.
With the MHSA Three-Year Integrated Program and Expenditure Plan for FY2017/20 allocated programs, the CSU services continued to be a high priority among stakeholders. Solano continues to strive to improve its CSU services, especially in the area of capacity and overall integration with the larger mental health system and the community. The CSU is also viewed as a critical service by our local hospitals and law enforcement agencies.
On March 13, 2018, the Department issued a request for proposal (RFP) for the provision of a Crisis Stabilization Unit (RFP# 9487-0312-18). The County received four proposals in response to the RFP. After a review panel evaluated the submitted proposals, Crestwood was chosen as the best among the proposed vendors and invited to enter into a contract for FY 2017/18 in a Notice of Intent to Award released on April 17, 2018.
The Department has chosen Crestwood because of their culturally relevant services, compassionate trauma-informed service model, therapeutic environment, and utilization of evidence-based practices by the Commission on Accreditation of Rehabilitation Facilities, as well as their 50 years of experience in providing quality psychiatric services in communities across California. Crestwood has a long history of providing long-term care and began providing crisis stabilization services in 2008 in Kern County, and opened its first Psychiatric Health Facility in Bakersfield in 2010. Crestwood has collaborated with communities to provide psychiatric crisis services to those requiring intensive treatment programs with a high level of safety and structure, as well as providing opportunities for clients living in the community requiring support and education to live independently. Crestwood worked with the County, community partners and community stakeholders for two years to create, develop and license the Crestwood Psychiatric Health Facility (PHF) in 2014, located in Vallejo. Since opening the doors to the PHF, Crestwood has served of 2,100 clients with a 97.4% reintegration rate into the community. With a commitment to recovery, Crestwood proposes to integrate the same wellness oriented model to the CSU and focus on client self-management, recovery and efforts to stabilize clients within the least restrictive setting.
Several outcomes are monitored in accordance with this service delivery, which include seclusion and restraint rates, average length of stay, rates of discharge to the community versus inpatient hospitals, and customer satisfaction.
FINANCIAL IMPACT:
The total cost of the 3 year agreement with Crestwood is $13,139,264. The CSU is funded with MHSA Community Services and Support monies offset with Medi-Cal revenue generated. Funds for this contract are included in the FY18/19 Requested and Supplemental Budget. This item does not impact County General Fund.
ALTERNATIVES:
The Board may choose not to approve the contract with Crestwood. This is not recommended as it would severely limit the ability of the Department to provide emergent crisis stabilization services to Solano residents, and could result in increased psychiatric hospitalization rates. Community partners such as law enforcement, local hospital emergency departments, and others who have benefitted from the current crisis response system would also suffer negative clinical and fiscal effects.
OTHER AGENCY INVOLVEMENT:
Per the guidelines of the MHSA Community Planning process, multiple community-based organizations, and mental health service providers, consumers and their families, probation, law enforcement, school districts, family resource centers, hospitals and emergency departments, family members of consumers, and other stakeholders were involved in identifying the services needed to strengthen the mental health system of care as outlined in the MHSA Three-Year Integrated Program and Expenditure Plan for FY 2017/2020. Crisis stabilization services which were identified as a priority program are outlined in the -Community Supports and Services (CSS) component of the plan, County Counsel has reviewed the contract as to form.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION