AGENDA STAFF REPORT

Agenda Item AGENDA STAFF REPORT ASR Control 21-000090
MEETING DATE:	04/27/21
legal entity taking action:	Board of Supervisors
board of supervisors district(s):	All Districts
SUBMITTING Agency/Department:	Health Care Agency (Approved)
Department contact person(s):	Annette Mugrditchian (714) 834-5026
	Jeff Nagel (714) 834-7024

Subject: Renewal Amendment No. 3 to Residential and Enhanced Residential Rehab 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 2021-22 $1,779,700

Staffing Impact:

# of Positions:

Sole Source: N/A

Current Fiscal Year Revenue: N/A

Funding Source: FED: 82% (Mental Health Block Grant), State: 18% (Mental Health Services Act/Prop 63)	County Audit in last 3 years: No

Prior Board Action: 05/19/2020 #22, 01/29/2019 #24, 05/09/2017 #26

RECOMMENDED ACTION(S):

Approve Amendment No. 3 to renew the Contract with various providers for Provision of Mental Health Residential Rehabilitation and Mental Health Enhanced Residential Rehabilitation Services, for the term of July 1, 2021, through June 30, 2022, for an annual amount not to exceed $1,779,700, for a revised cumulative total amount not to exceed $8,259,472.

Authorize the County Procurement Officer or authorized Deputy to execute Amendment No. 3 to the Contract with various providers, as referenced in the Recommended Action above.

SUMMARY:

Approval of Amendment No. 3 to renew the Contract with various providers for the provision of Mental Health Residential Rehabilitation and Mental Health Enhanced Residential Rehabilitation Services will provide direct services to clients in a licensed facility who are diagnosed with a serious mental illness and reside in Orange County

BACKGROUND INFORMATION:

Your Honorable Board of Supervisors (Board) approved the Master Agreement and Amendments below for provision of Mental Health Residential Rehabilitation (Res Rehab) and Mental Health Enhanced Residential Rehabilitation (ERR) Services and the below additional actions have been executed pursuant to appropriate authorities.

Board Date	Contract/Amendment	Action	Term
May 9, 2017	Contract	Board Approved Master Agreement	July 1, 2017-June 30, 2020
January 29, 2019	Amendment No. 1	Board Approve Master Agreement Cost Increase	July 1, 2017- June 30, 2020
May 19, 2020	Amendment No. 2	Board Approved Master Agreement Term Renewal	July 1, 2020- June 30, 2021

The proposed Amendment No. 3 will allow services to continue through June 30, 2022.

Scope of Services

The Res Rehab facilities are licensed by Community Care Licensing and have the capacity to serve up to 157 individuals per day. The target population is adults living with a serious mental illness and/or co-occurring disorder, and who are being discharged from a hospital or Long Term Care facility, who have failed multiple placements in licensed Adult Residential Facilities or require additional services in order to successfully remain in the community. Services include but are not limited to social skills training, pre-vocational and vocational activities, physical activities, transportation to essential appointments and medication support services.

The five providers under the current Contract are identified below and are anticipated to continue to provide services in FY 2021-22.

Provider Name	Location
BMD ResCare, Inc. dba Caring Village	Anaheim
BMD ResCare, Inc. dba Palm Village	Garden Grove
Founder's House of Hope, Inc.	Artesia
Leisure Tower II Residential Care, Inc.	Anaheim
Stanford Homes, Inc.	Fullerton

Performance Outcomes

Goals		80% of residents will not be hospitalized within the first six month	60% of Discharged Residents will move to Lower Levels of Care
Period Reported	Total Served	% Not Hospitalized First six months	% Moved to Lower Level of Care
FY 2018-19	207	83%	45%
FY 2019-20	169	89%	62%

In FY 2019-20, the Covid-19 pandemic affected the Res Rehab discharge rate. Individuals who were scheduled to discharge to a lower level of care remained placed at the Res Rehabs due to safety and a lack of vacancies at the basic board and cares.

Scope of Services

The ERR facilities are licensed by Community Care Licensing and have the capacity to serve up to 19 individuals per day. The target population is adults living with a serious mental illness, who are currently on or are at risk of being placed on Lanterman-Petris-Short conservatorship, who may be residing in an Institute for Mental Disease and who have previously failed placement in the community due to the severity of their illness. The services provided are targeted to helping them regain control of their independence, reintegrate into the community, be closer to their families and support systems and achieve recovery.

The ERR providers work in collaboration with the County and Full Service Partnership providers to support the individuals’ milestones, goals and movement along the housing continuum and provide specifically tailored interventions that focus on behaviors that caused failed placements in the past. This may include one-on-one interventions and daily interactions with each individual, and ERR providers are required to provide additional staff to work with each person individually during the evening and weekend hours, as well as to engage those individuals in social or other related activities during those times.

The providers under the current Contract are identified below and are anticipated to continue to provide services in FY 2021-22.

Provider Name	Location
BMD ResCare, Inc. dba Palm Village	Garden Grove
Stanford Homes, Inc.	Fullerton

Performance Outcomes

Goals		50% of residents will not be hospitalized within the first six month	50% of Discharged Residents will move to Lower Levels of Care
Period Reported	Total Served	% Not Hospitalized First six months	% Moved to Lower Level of Care
FY 2018-19	35	94%	65%
FY 2019-20	30	86%	71%

The Contractors’ performances have been confirmed as satisfactory. The Health Care Agency (HCA) has verified there are no concerns that must be addressed with respect to the Contractors’ ownerships/names, litigation status or conflicts with County interests.

These contracts do not currently include subcontractors or pass through to other providers. See Attachment C for the Contract Summary Form.

HCA works collaboratively with each provider to develop a good neighbor policy as required by their contract. To date, HCA has not received any negative feedback from the cities of Anaheim, Artesia, Fullerton or Garden Grove where these services are conducted.

HCA requests the Board approve Amendment No. 3 to the Contract for provision of Mental Health Residential Rehabilitation Services and Mental Health Enhanced Residential Rehabilitation Services with various providers as referenced in the Recommended Actions.

FINANCIAL IMPACT:

Appropriations for this Amendment will be included in Budget Control 042 FY 2021-22 Budget.

Should services need to be reduced or terminated due to lack of funding, the Contract contains language that allows HCA to give a 30-day notice to either terminate or renegotiate the level of services to be provided. The notice will allow HCA adequate time to transition or terminate services to clients, if necessary.

STAFFING IMPACT:

N/A

ATTACHMENT(S):

Attachment A - Amendment No. 3 Contract MA-042-18010346 for provisions of Mental Health Residential Rehabilitation and Mental Health Enhanced Residential Rehabilitation Services
Attachment B - Redline Version to Attachment A
Attachment C - Contract Summary Form