Approve seventh amendment to Agreement No. 20-04 with BHC Heritage Oaks Hospital, to add funding in the amount of $201,000 for fiscal year 2022-23, for a new contract maximum of $3,433,812 for the period of July 1, 2019 through June 30, 2024, to provide psychiatric health facility services. (No general fund impact) (Sullivan)

Approve seventh amendment to Agreement No. 20-04 with BHC Heritage Oaks Hospital, to add funding in the amount of $201,000 for fiscal year 2022-23, for a new contract maximum of $3,433,812 for the period of July 1, 2019 through June 30, 2024, to provide psychiatric health facility services. 

California state law mandates the County to provide psychiatric inpatient hospital services to eligible Medi-Cal and non-Medi-Cal mental health consumers.  Woodland Memorial Hospital is the designated and responsible hospital to provide these services to Yolo County resident adults (age 18 or older) who meet California Welfare and Institutions Code criteria and/or who are a danger to self, others or are gravely disabled and require inpatient acute psychiatric services.

When no adult bed space is available at Woodland Memorial Hospital, or when a child or adolescent needs acute psychiatric care, they must be treated by another qualified psychiatric fee-for-service hospital in the surrounding area.  BHC Heritage Oaks Hospital, being such a facility and being located relatively close to Yolo County, is equipped to provide appropriate services to meet our clients’ needs, regardless of client age.

The County is responsible for serving all Yolo Medi-Cal beneficiaries regardless of age.  The Contractor is not certified to bill Medi-Cal for services provided to Yolo Medi-Cal beneficiaries whose age is between 21 and 64 years of age. Thus, federal financial participation (FFP) is not available for these services. The stated contract amount is to be used for funding the services related to this group.

For services provided to Yolo Medi-Cal beneficiaries whose age is either 20 or younger, or 65 or older, the payment to the Contractor for this population is not paid directly via the County.  The Contractor bills Medi-Cal directly to receive funding via FFP and the County’s mental health realignment funds.  The State then reduces the amount used for this purpose from the monthly realignment apportionment to the County. 

On or about January 14, 2020, the County entered into an Agreement with BHC Heritage Oaks with an initial term of July 1, 2019 through June 30, 2022 with a contract maximum of $1,620,000. The Agreement also included 2 optional extensions for FY 2022-23 and 2023-24.

On or about June 23, 2020, the Parties amended the agreement via the first amendment to add $100,000 for FY 2019-20 for a new contract maximum of $1,720,000.

On or about August 4, 2020, the Parties further amended the agreement via the second amendment to add funding in the amount of $91,812 for FY 2019-20 and reduced funding in the amount of $40,000 for FY 2020-21 and 2021-22 for a new contract maximum of $1,731,812.

On or about September 1, 2020, the Parties further amended the agreement via the third amendment to add funding in the amount of $45,000 for FY 2019-20 for a new contract maximum of $1,776,812.

On or about October 12, 2021, the Parties further amended to the agreement via the fourth amendment to add funding in the amount of $220,000 for FY2020-21 for a new contract maximum of $1,996,812.

On or about March 24, 2022, the County exercised the option to extend the Agreement through Fiscal Year 2022-23 under the same terms and conditions and added $500,000 for Fiscal Year 2022-23.

On or about June 7, 2022, the Parties further amended the agreement via the fifth amendment to add funding in the amount of $111,000 for FY2021-22 and $125,000 for FY2022-23 for a new contract maximum of $2,732,812 and to update contract language.

On or about December 14, 2022, the Parties further amended the agreement via the sixth amendment to update contract language.

On or about June 7, 2023, the County exercised the option to extend the Agreement through Fiscal Year 2023-24 under the same terms and conditions and added $500,000 for Fiscal Year 2023-24.

Approval of this seventh amendment is necessary to cover the remaining claims for fiscal year 2022-23.  Additional annual funding as of fiscal year 22-23 is needed as actual costs each year have surpassed previously planned annual budgets and resulted in repeated contract budget amendments.    

Performance Measures included in this Agreement are as follows:
The Performance Measures were included in the underlying Agreement and are not being revised at this time (See Att. B. Performance Measures)

HHSA confirms BHC Heritage Oaks Hospital has performed satisfactorily under this agreement. Heritage Oaks Hospital served 39 unduplicated client and admitted 43 inpatient clients in 2022-23. There was a total of 594 inpatient treatment days in 2022-23. The average length of stay was 13.8 days. There were zero clients who did not experience a psych readmission within 7 days of Discharge and zero clients who did not experience a psych readmission within 30 days of discharge.

County Counsel has approved this Agreement as to form.

This agreement was sought through a Sole Source, which was approved by the Procurement Manager on April 29, 2019.

Procurement reviewed HHSA’s request and determined that it was in the best interest of the County, based on satisfactory service/reasonable prices and to avoid the interruption of County business, to approve the sole source. Without sole source approval of the agreement with the vendor, the County would be unable to meet the state mandate standards. Factors considered, included but were not limited to:
1) vendor has bed availability and is close in proximity to Yolo for when the in-County facility has no bed space; 2) satisfactory vendor performance--the vendor has been a County vendor for over five years; 3) competitive pricing, vendor charges the County Medi-Cal rate which is standard and reasonable; and 4) reduced ability to care for residents in acute crisis who need psychiatric inpatient service for stabilization, which would put consumers, their loved ones and the community as a whole at risk.