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Approve a second contract amendment with Crestwood Behavioral Health, Inc. for $265,000 for a total contract amount of $6,688,828 to provide psychiatric medical services from July 1, 2019 through June 30, 2020; 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 of Supervisors approve a second contract amendment with Crestwood Behavioral Health, Inc. for $265,000 for a total contract amount of $6,688,828 to provide psychiatric medical services from July 1, 2019 through June 30, 2020, and authorize the County Administrator to execute the amendment.
SUMMARY:
Crestwood Behavioral Health, Inc. provides inpatient psychiatric services within their Psychiatric Hospital Facility (PHF). Under the current contract, Crestwood Behavioral Health, Inc. provides assessment, diagnosis, and psychiatric inpatient treatment services for Solano County responsible clients in a 24-hour secure setting. Individuals are typically admitted to the PHF when placed on a Welfare and Institution (W&I) Code 5150, which indicates the individual is a danger to self, others, or gravely disabled due to a mental illness.
This second amendment provides for the equivalent of 315 additional acute psychiatric bed days to fund an active capacity of ten beds per day, due to increased costs of operation and the daily rates charged to the County. Indigent clients who do not have Medi-Cal coverage also require a small differential payment, and more indigent clients were admitted in FY2019/20 than were originally anticipated based on historical data.
FINANCIAL IMPACT:
Funding for this amendment is from Federal Short Doyle Medi-Cal, 1991 and 2011 Realignment, and County General Fund. Appropriations are available in the Department’s FY2019/20 Adopted Budget to fund this amendment and an accrual has been created to charge the expenditure to the proper fiscal year. There is no additional financial impact to the County General Fund.
DISCUSSION:
On June 26, 2018, the Board of Supervisors approved a $6,423,828 contract with Crestwood Behavioral Health, Inc. for the period beginning July 1, 2018 through June 30, 2020. To maintain an effective inpatient system of care, Health & Social Services contracts with hospitals and psychiatric health facilities that flexibly accept and treat individuals who are placed under a Welfare and Institution Code 5150 hold with the primary focus of locating the appropriate level of care for an individual with persistent mental illness who is experiencing an acute exacerbation of symptoms. Admissions average ten days and are most commonly between five and fourteen days.
Crestwood Behavioral Health, Inc. is a 16-bed inpatient facility in which Solano County purchases ten (10) of the beds. The balance of the beds are purchased by Napa County (two) and San Joaquin County (four). The contracting model for this facility was intended to operate through County cooperation to mitigate financial risk to Solano County.
This is the second contract amendment for Crestwood Behavioral Health, Inc. PHF. The first amendment was for a rate increase for FY2019/20 but the original contract amount was not sufficient to cover the actual increases in total costs to operate the ten bed census.
ALTERNATIVES:
The Board may choose not to approve the second contract amendment for Crestwood Behavioral Health, Inc. This is not recommended as the County is mandated to provide psychiatric services for clients served in the County mental health system who need this inpatient level of care for their own safety and the safety of the community and clients were served for this purpose in FY2019/20. This second amendment will ensure continued inpatient psychiatric hospitalization services.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved the contract for legal sufficiency.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION