Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  16-001221

 

MEETING DATE:

02/14/17

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

1

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Jeff Nagel (714) 834-7024 

 

 

Mary Hale (714) 834-6032

 

 

Subject:  Agreement for Crisis Stabilization Services

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: N/A

Current Year Cost: N/A

Annual Cost: FY 2017-18 $9,135,097
FY 2018-19 $7,424,238
FY 2019-20 $7,424,238

 

 

 

    Staffing Impact:

No

# of Positions:

Sole Source: N/A

    Current Fiscal Year Revenue: N/A

  Funding Source: See Financial Impact Section

County Audit in last 3 years: No

 

 

    Prior Board Action: N/A

 

RECOMMENDED ACTION(S):

 

 

1.

Approve the selection of and the Agreement with Exodus Recovery, Inc., for provision of Crisis Stabilization Services, for the period of July 1, 2017, through June 30, 2020, for a total maximum obligation of $23,983,573.

 

2.

Authorize the Health Care Agency Director, or designee, to exercise a contingency contract cost increase in an amount not to exceed 10% of the original amount of the first year of funding for this Agreement with Exodus Recovery, Inc., for provision of Crisis Stabilization Services, for the entire term and within the scope of work set forth in the Agreement, pursuant to Contract Policy Manual Section 3.3-113.

 

3.

Authorize the Health Care Agency Director, or designee, to execute the Agreement with Exodus Recovery, Inc., for provision of Crisis Stabilization Services as referenced in the Recommended Actions above.

 

 

 

 

 

SUMMARY:

 

The Health Care Agency requests the selection of, and Agreement with Exodus Recovery, Inc., for provision of Crisis Stabilization Services.

 

 

 

 

BACKGROUND INFORMATION:

 

On May 31, 2016, the Health Care Agency (HCA) released a Solicitation of Interest (SOI) in response to Board of Supervisors direction to add capacity to our existing County-operated Crisis Stabilization Unit (CSU). The intent of the SOI was to establish at least one hospital-based or affiliated CSU that would be Lanterman-Petris-Short Act (LPS) designated (locked) and one CSU that would be voluntary. Seven statements of interest were received and reviewed by County staff and all were deemed responsive. Two proposed LPS designated CSUs, three proposed voluntary CSUs, and two proposed both LPS designated and voluntary CSUs. HCA began contract negotiations with the four organizations that proposed LPS designated facilities, with the expectation that the California Health Facilities Financing Authority (CHFFA) grant may provide the funding for all or part of the development, capital, equipment acquisition, and program start-up costs needed for the LPS designated CSUs. The organizations that proposed voluntary CSUs were notified that due to the number of responses received for the voluntary CSUs, the County has determined that the next step of the solicitation process will be a Request for Proposals (RFP) for voluntary crisis stabilization services to be developed and released once contract negotiations for the LPS designated facilities is completed.  

 

The first of the contract negotiations for an LPS designated CSU has been completed. Due to the timeframes required for CHFFA funded projects, HCA recommends approval and execution of an Agreement with Exodus Recovery, Inc. (Exodus) for provision of Crisis Stabilization Services (Agreement) as they meet CHFFA readiness requirements, for the provision of outpatient crisis stabilization services. HCA will return to the Board for approval of additional agreements for CSU services as additional contract negotiations are completed.

 

CSU services are designed to serve as a viable option for persons in psychiatric crisis. Services include: psychiatric assessment; physical screening; medication services; collateral history; therapy; crisis intervention; education; nursing assessment; coordination of referrals to continuing care and emergency housing; discharge planning and facilitation of transfer of clients to inpatient treatment facilities when clinically appropriate and indicated.

 

The target population is youth ages 13 and above, adults and older adults, who are experiencing a psychiatric emergency, cannot wait for a regularly scheduled appointment and are at risk for hospitalization or out of home placement. The CSU will provide services to all persons meeting criteria who present on a walk-in basis, by police-drop off and emergency department referral. The CSU will operate on a 24 hours a day, seven days a week basis.  As a designated outpatient facility, the facility may evaluate and treat clients for no longer than 23 hours and 59 minutes.

 

Services will be provided in a facility in the City of Garden Grove that will have a separate entrance, as well as waiting and treatment areas for youth apart from the adult client population. Exodus has an affiliation with St. Joseph’s Hospital that will be providing the facility along with necessary facility renovations.

 

The performance expectation is for the CSU to serve an average daily census of 22 unduplicated Medi-Cal clients. Additional performance outcomes will be established in negotiation with the provider.

 

This Agreement does have subcontracts with psychiatrists who will provide required medication services to clients. The estimated amount for these subcontracts is $199,032 annually. This Agreement also has subcontracts for security services and the estimated amount for this subcontract is $181,038. See Attachment B for Contract Summary Form.

 

HCA requests that the Board authorize the HCA Director or designee, to exercise a contingency contract cost increase in an amount not to exceed 10% of the original amount of the first year of funding for this Agreement with Exodus, for the entire term and within the scope of work set forth in the Agreement, pursuant to Contract Policy Manual Section 3.3-113.  The contingency provision would be exercised in the event of an unanticipated increase in the need for services within the scope of work of the proposed Agreement.

 

HCA requests that the Board approve the selection of and Agreement with Exodus Recovery, Inc., for Provision of Crisis Stabilization Services as referenced in the Recommended Actions.

 

 

FINANCIAL IMPACT:

 

Appropriations for this Agreement will be included in HCA's budgeting process for FY 2017-18 and future fiscal years.

 

Funding Sources:

 

State: 54% (California Health Facilities Financing Authority, Mental Health Services Act/Prop 63)

Fees/Other: 46% (Federal Financial Participation Medi-Cal)

 

Should services need to be reduced or terminated due to lack of funding, this Agreement contains language that allows Health Care Agency to give a 180-day notice to either terminate or renegotiate the level of services to be provided.  The notice will allow Health Care Agency adequate time to transition or terminate services to clients, if necessary.

 

 

 

STAFFING IMPACT:

 

N/A

 

 

 

ATTACHMENT(S):

 

Attachment A - Agreement for Provision of Crisis Stabilization Services between County of Orange and Exodus Recovery, Inc.
Attachment B - Contract Summary Form