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Agenda Item
ASR
Control 24-000550 |
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MEETING
DATE: |
12/17/24 |
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legal entity taking action: |
Board
of Supervisors |
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board of supervisors district(s): |
All
Districts |
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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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Ian
Kemmer (714) 834-2160 |
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Subject: Master Contract Adult Long Term
Care Institutions for Mental Disease Services
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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: $6,500,000 |
Annual Cost: FY 2025-26 $11,500,000 |
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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: 5/21/2024 #27, 5/24/2022 #42,
5/21/2019 #44 |
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RECOMMENDED
ACTION(S):
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1. |
Approve the Master Contract and
individual contracts with various providers for provision of Adult Long Term
Care Institutions for Mental Disease Services, for the term of January 1,
2025, through June 30, 2026, for a total aggregate amount not to exceed $18,000,000,
renewable for three additional one-year terms. |
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2. |
Pursuant to Contract Policy Manual
Section 3.3-113, authorize the County Procurement Officer or Deputized
designee to exercise a contingency contract cost increase in an amount not to
exceed $650,000, 10 percent of the contract amount for the first year of the
Contract, for provision of Adult Long Term Care Institutions for Mental
Disease Services for the entire term of the Contract, including renewals, and
within the scope of work set forth in the contract. The use of the
contingency contract cost increase is subject to approval requirements
established by the County Procurement Officer. |
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3. |
Authorize the County Procurement Officer
or Deputized designee to execute the Master Contract and Individual Contracts
with various providers for Adult Long Term Care Institutions for Mental
Disease Services, as referenced in the Recommended Actions above. |
SUMMARY:
Approval of the Master Contract and
individual contracts with various providers for provision of Adult Long Term
Care Institutions for Mental Disease Services will provide adult intensive
treatment services to adult residents of Orange County living with a serious
mental illness.
BACKGROUND
INFORMATION:
IMDs are the highest level of care
within the LTC continuum of treatment. The target population for IMDs are
adults living with a serious mental illness, who may also experience co-occurring
medical and/or substance use conditions. The goal of IMDs is to increase
clients daily functioning skills and prepare clients for transitioning to less
restrictive levels of care and support. IMDs are licensed as either a SNF with
Special Treatment Programs (STP) or as Mental Health Rehabilitation Centers
(MHRC). Services are provided in locked facilities that operate 24 hours per
day, seven days per week, and provide recovery-based mental health services
including medication management and a minimum of 27 hours per week of
structured therapeutic group activities.
On May 21, 2019, your Honorable
Board of Supervisors (Board) previously approved the Contracts for Adult Mental
Health Psychiatric Skilled Nursing Facility (SNF) Services which included Long
Term Care (LTC) Institutions for Mental Disease (IMD) Services. All prior
actions are included in the table below:
|
Board Date |
Contract/Amendment |
Action |
Term |
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May
21, 2019 |
Master
Contract for Adult Mental Health Psychiatric Skilled Nursing Facility
Services |
Board
approved Master Contract |
July
1, 2019 - June 30, 2022 |
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May
24, 2022 |
Amendment
No. 1 |
Board
approved Master Contract Amendment with various contractors for two-year
renewal |
July
1, 2022 - June 30, 2024 |
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N/A |
Amendment
No. 2 |
Deputy
Purchasing Agent (DPA) delegated Authority amendment for various
administrative revisions and contingency cost increase |
April
10, 2024 - June 30, 2024 |
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May
21, 2024 |
Amendment
No. 3 Approval
of Contract |
Board
approved Master Contract Amendment to extend the contract for six months and
increase funds with various Contractors Board
approved Contract |
July
1, 2024 - December 31, 2024 July
1, 2024 - June 30, 2026 |
Request
for Proposal
On August 8, 2024, the HCA released
a RFP in the County’s online bidding system to solicit proposals from qualified
providers to provide Adult LTC IMD Services. HCA received two proposals from KF
Community Care, LLC dba Community Care Center and Sylmar Health &
Rehabilitation Center, Inc. The Orange County Preference Policy is not
applicable to this Contract.
Proposal
Evaluation Process
A standard evaluation panel of five
members, comprised of two HCA staff and three members of the public with
subject matter expertise, was recruited to evaluate proposals received.
Evaluation panel members independently rated the proposals using the following
criteria and possible maximum points:
|
Evaluation
Criteria |
Maximum
Points |
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Firm’s
Background, Qualifications & Experience |
200 points |
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Services |
200 points |
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Performance
Objectives |
100 points |
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Staffing |
100 points |
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Facility |
200 points |
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Cost Proposal |
100 points |
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Presentation/Interview |
100 points |
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Total Maximum Points: |
1000 points |
The evaluation panel evaluated the
proposals and recommended to award contracts to KF Community Care, LLC dba
Community Care Center and Sylmar Health & Rehabilitation Center, Inc.
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Proponent |
City/State |
Average
Score |
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KF Community
Care, LLC dba Community Care Center |
Duarte, CA |
659 |
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Sylmar Health
& Rehabilitation Center, Inc. |
Sylmar, CA |
822 |
HCA staff have conducted due
diligence on the Contractors. Reference checks were satisfactory and completed
with the following (by contract provider):
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Proponent |
Reference Checks |
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KF
Community Care, LLC dba Community Care Center |
Diagnostic
Laboratories & Technology, DietPro Inc. and Right Track Healthcare
Management & Solutions |
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Sylmar
Health & Rehabilitation Center, Inc. |
Department
of State Hospitals, San Bernardino County Behavioral Health and Ventura
County Behavioral Health |
HCA has verified there are no
concerns that must be addressed regarding each Contractor’s ownership/name,
litigation status, or conflicts with County interests.
Performance
Outcomes
The current contract for Adult LTC
IMD Services tracks and reports the number of persons served and average length
of stay (LOS). ). The previous LTC IMD Services contract did not include any
established goals to assess the program’s effectiveness. The table below
presents the actual program results for Fiscal Year (FY) 2022-23 and FY
2023-24.
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Fiscal
Year |
Number
of clients served |
Average
Length of Stay |
Percent
of Clients Discharged to a Lower Level of Care |
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2022-23 |
43 |
2 years |
55% |
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2023-24 |
23 |
4 years |
60% |
In addition to continuing to
monitor these activities, HCA has developed Outcome Measures across the system
of care for the IMD services presented in the table below to better evaluate
the effectiveness of the programs. HCA plans to continue to review and evaluate
the outcomes, making adjustments as appropriate.
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New
Outcome Measures |
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90%
of clients will discharge to a lower level of care 100%
of clients assessment & treatment plan will be completed within 30 days
of admission 90%
of clients will participate in group/individual therapy & social
activities |
The contracts, due to the nature of
the services, could require the addition of subcontractors. In order to add
subcontractor(s) to the contract(s), the provider/contractor must seek express
consent from HCA. Should the addition of a subcontractor affect the scope of
work and/or contract amount, HCA will bring the item back to the Board for
approval. See Attachment B for Contract Summary Form.
Pursuant
to Contract Policy Manual Section 3.3-113, authorize the County Procurement
Officer, or Deputized designee, to exercise a contingency contract cost
increase not to exceed 10 percent of the contract amount for the first year of
the Contract for Adult LTC IMD Services for the entire term of the contract
including renewals, and within the scope of work set forth in the contract. The
use of this contingency contract cost increase is subject to approval
requirements established by the County Procurement Officer. The contingency
provision would be exercised in the event there is an increase in the projected
services needed for the clients being served.
This
Master Contract is submitted for approval less than 30 days before its
effective date due to an extended negotiation period over the terms and
conditions in the Contract and to prevent disruption in services.
HCA requests that the Board approve the
Master Contract and individual contracts with various providers for provision
of Adult Long Term Care Institutions for Mental Disease Services, as referenced
in the Recommended Actions.
FINANCIAL
IMPACT:
Appropriations for the Master
Contract and individual contracts with various providers are included in Budget
Control 042 FY 2024-25 Budget and will be included in the budgeting process for
future years.
The proposed Contracts include provisions
allowing HCA to terminate the Contract, 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 - Master Contract MA 042-25010173 for Provision of Adult Long Term Care
Institutions for Mental Disease Services
Attachment B - Contract Summary Form
Attachment C – Scoring Sheets