Approve fourth amendment to Agreement No. 19-265 with Sutter Valley Hospitals dba Sutter Center for Psychiatry to add funding in the amount of $41,529 for 2023-24, for a new contract maximum of $2,419,529, for the period of July 1, 2019 through June 30, 2024 for the provisions of acute psychiatric inpatient services. (No general fund impact) (Sullivan)

Approve fourth amendment to Agreement No. 19-265 with Sutter Valley Hospitals dba Sutter Center for Psychiatry to add funding in the amount of $41,529 for 2023-24, for a new contract maximum of $2,419,529, for the period of July 1, 2019 through June 30, 2024 for the provisions of acute psychiatric inpatient 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 residents 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 services, the patient must be treated by another qualified psychiatric hospital facility in the surrounding area.  Sutter Center for Psychiatry, being such a facility, is equipped to provide appropriate services to meet our clients’ needs.

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 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 $400,000 for Fiscal Year 2022-23.

On or about May 24, 2022, the parties amended the Agreement to add funding for 2021-22 to cover the remaining claims for acute inpatient hospital stays for fiscal year 2021-22 so that the County would continue providing acute psychiatric inpatient services to adults with severe mental illness.

On or about June 14, 2023, the County exercised the option to extend the Agreement through Fiscal Year 2023-24 under the same terms and conditions and added $400,000 for Fiscal Year 2023-24.

Staff recommends approval of this Amendment to cover the remaining claims for acute inpatient hospital stays for fiscal year 2023-24 to ensure that mandatory services that occurred in fiscal year 2023-24 are paid in full.

Performance Measures included in this Agreement are as follows:
Performance measures were included in Agreement No. 19-265 and are not being changed by this amendment.

The Department confirms Sutter Center for Psychiatry has performed satisfactorily on the current agreement. In 2023-24, the provider served 86 clients. 6 out of 86 clients (7%) were re-admitted to this facility within 7 days of discharge and 77% (67 out of 86 clients) did not re-admit to any inpatient facility within 30 days of discharge from this facility.

County Counsel has approved this Amendment as to form.

This agreement was sourced via a Sole Source Letter approved by Procurement Manager. There are no changes being made to the scope of work.

Procurement reviewed HHSA’s request and determined that it was in the best interest of the County based on satisfactory service/reasonable prices to approve the sole source. Without sole source approval of the agreement with the vendor, the County would have a reduced ability to care for residents in acute crisis who are in need of psychiatric inpatient services to stabilize. This would place these consumers, their loved ones and the community at risk. The County would also, in some instances, be unable to meet state mandated standards regarding the provision of care for persons deemed a risk to themselves or to others. Factors considered, included but were not limited to 1) the price for this service is fair and reasonable as Sutter Center for Psychiatry charges current Medi-Cal Day rates and 2) The sole (in county) provider for these services has a finite number of adult beds and do not have beds for consumers younger than 21 years of age or older than 64 years of age, whereas Sutter does.