TO: Board of Supervisors
FROM: Jennifer Yasumoto, Health & Human Services
REPORT BY: Gaby Angeles, Staff Services Analyst II
SUBJECT: Agreement with Crestwood Behavioral Health, Inc. Agreement No. 220164B
RECOMMENDATION
title
Director of Health and Human Services requests approval of and authorization for the Chair to:
1) Terminate the current Agreement No. 170496B with Crestwood Behavioral Health, Inc. for a maximum of $800,000; and
2) Sign a new Agreement No. 220164B with Crestwood Behavioral Health, Inc. for a maximum of $875,000 with the term commencing upon approval through June 30, 2022, with a provision for four annual renewals to provide residential care and mental health services.
body
EXECUTIVE SUMMARY
The purpose of today's requested actions are to terminate the original contract with Crestwood Behavioral Health, Inc., which has reached a large number of amendments, and replace it with a new Agreement to provide residential care and mental health services. The new agreement includes a $75,000 contract maximum increase due to an increase in the level of usage. Crestwood Behavioral Health, Inc. is not a local vendor.
FISCAL & STRATEGIC PLAN IMPACT
|
Is there a Fiscal Impact? |
Yes |
|
Is it currently budgeted? |
Yes |
|
Where is it budgeted? |
Health & Human Services Mental Health |
|
Is it Mandatory or Discretionary? |
Discretionary |
|
Is the general fund affected? |
No |
|
Future fiscal impact: |
The Agreement contains a provision for automatic annual renewal. Appropriations have been included in the approved Fiscal Year 2021-2022 budget and future fiscal years will be budgeted accordingly. |
|
Consequences if not approved: |
If not approved, it would severely limit HHSA's capacity to provide mandated inpatient psychiatric hospitalization services at the appropriate level of care. |
|
County Strategic Plan pillar addressed: |
Healthy, Safe, and Welcoming Place to Live, Work, and Visit |
ENVIRONMENTAL IMPACT
ENVIRONMENTAL DETERMINATION: The proposed action is not a project as defined by 14 California Code of Regulations 15378 (State CEQA Guidelines) and therefore CEQA is not applicable.
BACKGROUND AND DISCUSSION
The Crestwood Solano Psychiatric Health Facility (Crestwood PHF) is a 16-bed mental health stabilization program located in Vallejo, California. Crestwood PHF provides a secure structured program for individuals experiencing a psychiatric crisis requiring 24-hour observation and stabilization by a team of professional staff. The facility admits individuals 18 years of age or older, who may be admitted either on a voluntary or involuntary basis. Crestwood PHF provides an alternative to traditional psychiatric care and provides stabilization for residents of Napa County experiencing an acute psychiatric emergency of such magnitude that it is unmanageable in the community. Health and Human Services Agency (HHSA) clients placed at this facility are referred from the HHSA Mental Health Division's Crisis Stabilization Services Program, which has a maximum placement of 23 hours.
Approval of this amendment will increase the contractor's maximum by $75,000 to $875,000. Costs under this Agreement are incurred by the purchase of two beds, which the County pays for regardless of utilization. Because these costs are essentially “fixed”, there has not been a need to increase the contract maximum over the past few years. However, Crestwood PHF increases their bed day rates every year, which raises the Agreement’s annual fixed costs. Additionally, over the past few years, HHSA has periodically purchased bed days from other counties not utilizing their allotted bed space. The necessity of purchasing bed days from other counties has allowed for greater utilization than accounted for in the current contract maximum. The purchase of extra bed days combined with annual rate increases has resulted in a need to raise the contract maximum.
Purchasing extra bed days is a less costly alternative to other placement options and ensures that clients receive the treatment needed to stabilize their symptoms so they can be placed at a lower level of care.
Crestwood PHF is not a local vendor.