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Agenda Item
ASR
Control 23-000668 |
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MEETING
DATE: |
02/06/24 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
2,
3, 4 |
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SUBMITTING Agency/Department: |
Health
Care Agency (Approved) |
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Department contact person(s): |
Annette
Mugrditchian (714) 834-5026 |
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Veronica
Kelley (714) 834-7024 |
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Subject: Renewal Amendments Adult Crisis
Residential Services Central, North and South
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ceo CONCUR |
County Counsel Review |
Clerk of the Board |
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Concur |
Approved
Agreement to Form |
Discussion |
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3
Votes Board Majority |
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Budgeted: Yes |
Current Year
Cost: $295,235 |
Annual Cost: FY 2024-25 $6,164,265 |
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Staffing Impact: |
No |
# of Positions: |
Sole Source: No |
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Current Fiscal Year Revenue: N/A
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Prior Board Action: 5/10/2022 #26, 5/25/2021 #27,
6/23/2020 #10 |
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RECOMMENDED
ACTION(S):
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1. |
Approve
Amendment No. 3 to the Contract with Telecare Corporation for provision of
Adult Crisis Residential Services North Region, increasing amount not to
exceed by $104,730, effective February 6, 2024, through June 30, 2024, and to
renew the Contract for the term of July 1, 2024, through June 30, 2026, for
an amount not to exceed $3,314,089 for a revised cumulative contract total
amount not to exceed $7,466,008. |
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2. |
Approve
Amendment No. 3 to the Contract with Telecare Corporation for provision of
Adult Crisis Residential Services South Region, increasing amount not to
exceed by $190,505, effective February 6, 2024, through June 30, 2024, and to
renew the Contract for the term of July 1, 2024, through June 30, 2026, for
an amount not to exceed $3,136,179, for a revised cumulative contract total
amount not to exceed $7,082,665. |
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3. |
Approve
Amendment No. 4 to renew the Contract with Stars Behavioral Health Group,
Inc., dba Coastal Star Behavioral Health for provision of Adult Crisis
Residential Services Central Region, for the term of July 1, 2024, through
June 30, 2025, for an amount not to exceed $2,985,080, for a revised
cumulative contract total amount not to exceed $12,419,684. |
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4. |
Authorize the
County Procurement Officer or Deputized designee to execute the Amendments
No. 3 to the Contracts with Telecare Corporation, and Amendment No. 4 to the
Contract with Stars Behavioral Health Group, Inc., dba Coastal Star
Behavioral Health, as referenced in the Recommended Actions above. |
SUMMARY:
Approval of the Amendments to and
the renewal of the Contracts with Telecare Corporation and Stars Behavioral
Health Group, Inc., dba Coastal Star Behavioral Health for provision of Adult
Crisis Residential Services will allow services to continue to adults who are
in a mental health crisis and at risk of hospitalization and allow them to reside
safely in the community in the Central, North, and South Regions.
BACKGROUND
INFORMATION:
Your Honorable Board of Supervisors
(Board) approved the Contracts and Amendment for Adult Crisis Residential
Services North, South, and Central Regions with Telecare Corporation (Telecare)
and Stars Behavioral Health Group, Inc., dba Coastal Star Behavioral Health
(Coastal Star) as per the table below. All other Amendments not listed were
executed pursuant to delegated authority.
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Board Date |
Contract/Amendment |
Action |
Term |
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June
23, 2020 |
Contract
with Coastal Star |
Board
Approved Contract |
August
1, 2020 - June 30, 2022 |
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May
25, 2021 |
Contracts
with Telecare |
Board
Approved Contracts |
July
1, 2021 - June 30, 2024 |
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May
10, 2022 |
Amendment
No. 1 to Contract with Coastal Star |
Board
Approved Term Renewal |
July
1, 2022 - June 30, 2024 |
The Health Care Agency (HCA) is
requesting the Board approve Amendments No. 3 to the Contracts with Telecare to
increase current year funding under each Contract, as well as renew each
Contract for one two-year term for the North and South locations. HCA is also
requesting the Board approve Amendment No. 4 to the Contract with Coastal Star
to renew the Contract for a one-year term for the Central location for the
fifth and final year of its solicitation cycle. Prior to contract expiration,
HCA plans to issue a solicitation to continue services for the Central
location. The Orange County Preference Policy is not applicable to these
Amendments.
Scope
of Services
Adult Crisis Residential Services
are provided to adults who are in behavioral health crises and may be at risk
of psychiatric hospitalization. Services involve families and significant
others throughout the treatment episodes so that the dynamics of the clients’
circumstances are improved prior to discharge.
Crisis Residential Programs operate
24 hours a day, seven days a week, emulating home-like environments and
supporting social rehabilitation models designed to enhance clients’ social
connections with family or community to help them to return to their pre-crisis
level of functioning and prevent inpatient stays. The North Region provides
Adult Crisis Residential services to Orange County residents exclusively age 50
years and over and is referenced as the “Silver” Treehouse facility. The Adult
Crisis Residential programs in the South and Central Regions provide services
to Orange County residents ages 18 and over.
Crisis Residential services provide
alternatives for people experiencing acute psychiatric episodes or intense
emotional distress who might otherwise face inpatient treatment. Programs
provide crisis intervention, therapy, medication monitoring and evaluation to
determine the need and intensity of additional services within a framework of
evidence-based and trauma-informed approaches to recovery planning, including a
rich peer support component. These programs also include treatment for
co-occurring disorders and emphasize mastery of daily living skills and social
development using strength-based approaches that support recovery and wellness.
The residential settings create solid links to the continuum of care with
emphasis on housing supports and behavioral health linkages that will ease the
transition to the community and prevent recidivism.
Clients are referred from Adult and
Older Adult Behavioral Health County or County-contracted behavioral health
providers. Services include collaborating with existing behavioral health
providers to arrange for discharge planning, appropriate housing placements, as
needed, in addition to securing linkages to ongoing treatment providers prior
to discharge. These programs consist of two licensed, six-bed Crisis
Residential homes operated by Telecare, one in North Region and one in South
Region, and one 15-bed licensed facility, operated by Coastal Star in Central
Region. The average length of stay per client is approximately 17 days. Below
are the Performance Outcomes for FY 2021-22 and FY 2022-23. The proposed
outcomes for the renewal periods will remain the same for all amendments.
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FY 2021-22 |
FY 2022-23 |
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Contracted Outcomes for Treehouse South |
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Average
Length of Stay Per Client in Days |
8.1 |
9.4 |
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A
minimum of 75% discharged to a lower level of care |
72% |
80% |
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A
minimum of 70% linked to a continuing care provider |
65% |
71% |
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A
minimum of 95% not hospitalized within 48 hours of discharge |
100% |
99% |
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A
minimum of 75% not readmitted within 14 days of discharge |
100% |
98% |
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Contracted Outcomes for Treehouse North |
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Average
Length of Stay Per Client in Days |
10.8 |
25 |
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A
minimum of 75% discharged to a lower level of care |
75% |
77% |
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A
minimum of 70% linked to a continuing care provider |
75% |
71% |
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A
minimum of 95% not hospitalized within 48 hours of discharge |
99% |
100% |
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A
minimum of 75% not readmitted within 14 days of discharge |
97% |
99% |
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Contracted Outcomes for Coastal Star Central |
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Average
Length of Stay Per Client in Days |
15 |
26.2 |
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A
minimum of 75% discharged to a lower level of care |
86% |
92% |
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A
minimum of 70% linked to a continuing care provider |
85% |
89% |
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A
minimum of 95% not hospitalized within 48 hours of discharge |
100% |
100% |
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A
minimum of 75% not readmitted within 14 days of discharge |
91% |
98% |
The lengths of stay have gone from 11 to
20 days on average, allowing for more individuals to be successfully discharged
to lower levels of care and linked to ongoing mental health care to consolidate
treatment gains and reduce recidivism. Coastal Star and Silver Treehouse have
the longest lengths of stay due to this being a model that Coastal Star
utilizes in other Counties and due to the Silver Treehouse exclusively serving
individuals 50 years and older and linkage to ongoing physical and mental
health providers taking longer for this population. HCA is working with all
facilities to encourage ongoing linkage to occur during the client’s crisis
residential program stay.
The Contractors’ performances have been
confirmed as satisfactory. HCA has verified there are no concerns that must be
addressed with respect to Contractors’ ownership/names, litigation statuses or
conflicts with County interests. The proposed Amendments with Telecare North
and South Regions, and with Coastal Star Central Region include subcontracts
for psychiatry for provision of medication support. See Attachment D for
Contract Summary Forms.
HCA has developed a Good Neighbor Policy
that is included in Residential Program contracts wherein contractor provides
services to County residents and the services may have a potential impact on
the surrounding neighborhoods including but not limited to environment, safety,
and congregation. HCA has not received any negative feedback from the
communities and will continue to work with the contractor and the communities
to ensure positive community relations. The programs are located in the
following cities:
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Program |
Location |
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Adult Crisis Residential - North Region |
Anaheim |
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Adult Crisis Residential - South Region |
Mission Viejo |
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Adult Crisis Residential - Central
Region |
Orange |
HCA requests that the Board approve
Amendments No. 3 with Telecare, and Amendment No. 4 with Coastal Star for
provision of Adult Crisis Residential Services, as referenced in the
Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for these Contracts
are included in Budget Control 042 FY 2023-24 Budget and will be included in
the budgeting process for future years.
The Contracts include provisions
allowing HCA to terminate the Contracts, reduce the level of services, and/or
renegotiate the levels of services provided, as necessary. This includes a
notice that allows HCA adequate time to transition or terminate services to
clients, if necessary.
STAFFING
IMPACT:
N/A
ATTACHMENT(S):
Attachment
A – Amendment No. 3 to Contract MA-042-21011421 for Adult Crisis Residential
Services North Region with Telecare Corporation
Attachment B – Amendment No. 3 to Contract MA-042-21011417 for Adult Crisis
Residential Services South Region with Telecare Corporation
Attachment C – Amendment No. 4 to Contract MA-042-20011650 for Adult Crisis
Residential Services Central Region with Stars Behavioral Health Group, Inc.,
dba Coastal Star Behavioral Health
Attachment D - Contract Summary Forms
Attachment E - Redline Version to Attachment A
Attachment F – Redline Version to Attachment B
Attachment G – Redline Version to Attachment C