Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  24-000550

 

MEETING DATE:

12/17/24

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 

 

 

Ian Kemmer (714) 834-2160

 

 

Subject:  Master Contract Adult Long Term Care Institutions for Mental Disease Services

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: Yes

Current Year Cost:   $6,500,000

Annual Cost: FY 2025-26 $11,500,000

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:     State: 100% (Mental Health Realignment, Managed Care Realignment, and Tobacco Settlement Revenue)

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         5/21/2024 #27, 5/24/2022 #42, 5/21/2019 #44

 

RECOMMENDED ACTION(S):

 

 

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.

 

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.

 

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

May 21, 2019

Master Contract for Adult Mental Health Psychiatric Skilled Nursing Facility Services

Board approved Master Contract

July 1, 2019 - June 30, 2022

May 24, 2022

Amendment No. 1

Board approved Master Contract Amendment with various contractors for two-year renewal

July 1, 2022 - June 30, 2024

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

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

Firm’s Background, Qualifications & Experience

200 points

Services

200 points

Performance Objectives

100 points

Staffing

100 points

Facility

200 points

Cost Proposal

100 points

Presentation/Interview

100 points

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.

 

Proponent

City/State

Average Score

KF Community Care, LLC dba Community Care Center

Duarte, CA

659

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):

 

Proponent

Reference Checks

KF Community Care, LLC dba Community Care Center

Diagnostic Laboratories & Technology, DietPro Inc. and Right Track Healthcare Management & Solutions

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.

 

Fiscal Year

Number of clients served

Average Length of Stay

Percent of Clients Discharged to a Lower Level of Care

2022-23

43

2 years

55%

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.

 

New Outcome Measures

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