Authorize the Chair to execute a replacement agreement with North Valley Behavioral Health for Adult Inpatient Psychiatric Health Facility Services in compliance with the new California Advancing and Innovating Medi-Cal (CalAIM) initiative in an amount not-to-exceed $2,014,800 for the period of July 1, 2023 through June 30, 2024. (No general fund impact) (Sullivan)

On July 20, 2021, the County and North Valley Behavioral Health entered into Agreement No. 21-140, which provided an initial term of July 1, 2021 through June 30, 2024, with two optional extensions for FY’s 2024-25 ($2,014,800) and 2025-26 ($2,014,800) for the provision of psychiatric health facility (PHF) services. North Valley Behavioral Health operates two multidisciplinary inpatient PHF’s. The programs offer patient-centered with a “Patient’s First” philosophical approach and guided by a multidisciplinary team that provides individualized pharmacological, therapeutic, and rehabilitative interventions in a safe and secure environment.  Eligible clients are Yolo County residents who are 18 years or older with serious mental illness (SMI) who are deemed in need of the highest level of care provided in a non-state (local) hospital like facility.

California Advancing and Innovating Medi-Cal (CalAIM) Initiative
In January 2022, California Department of Health Care Services (DHCS) rolled out the CalAIM initiative that aims to provide broad delivery system program and payment reform across the Medi-Cal system. The goal is transformation of the Medi-Cal delivery system, moving it towards a population health approach that prioritizes prevention and whole person care. Focus shifts from compliance to quality and performance metrics. Specialty Mental Health Services (SMHS) requirements and policies pursuant to the CalAIM initiative were updated, and as a result of these updates, the County is required to revise the terms and conditions in the provider agreements for these services.  In preparation for this system wide change, the County has been working closely with CalMHSA who has been providing the County and other SMHS Medi-Cal counties with technical assistance around the CalAIM initiative. The County has received new boilerplate templates from CalMHSA for both DMC/SUD treatment services and SMHS Medi-Cal services that include updated programmatic regulatory requirements and updated billing/claiming requirements. County is working on finalizing a new Yolo County SMHS Medi-Cal boilerplate that is in compliance with these changes, a draft of which is attached hereto as Att. A. Draft Yolo County SMHS boilerplate.

The replacement agreement requested in this staff report will be drafted and executed on the finalized Yolo County SMHS boilerplate. County Counsel and the Procurement Division are participating in the review and finalization of the Yolo County SMHS boilerplate. However, due to the timeliness in which the County has been receiving information from DHCS, especially regarding rates, final boilerplate language is still pending.  Approval of this request herein will enable HHSA to expedite processing and approval of the replacement agreement once we have all of the information from DHCS and have negotiated final rates with our providers.

The replacement agreement will effectively terminate Agreement No. 21-140. While Agreement No. 21-140 provided two optional extensions for FY’s 2024-25 ($2,014,800) and 2025-26 ($2,014,800), due to the significant regulatory and claiming changes driven by the CalAIM initiative, the current agreement will expire on June 30, 2023, and cannot be extended on the same terms and conditions and must be replaced by a renewal agreement. HHSA now requests BOS approval of a one-year agreement with North Valley Behavioral Health for Adult Inpatient Psychiatric Health Facility Services in an amount not-to-exceed $2,014,800 for the period of July 1, 2023 through June 30, 2024, and delegated signing authority to the Yolo County Board Chair to assist with expediting execution of the renewal agreement. Based on guidance from County Counsel and the Procurement Division the optional extensions for FY’s 2024-25 ($2,014,800) and 2025-26 ($2,014,800) will not be included in this replacement agreement. County Counsel and the Procurement Division are working on updating the County long form contract boilerplate that will be forthcoming sometime in FY2023-24. County Counsel and the Procurement Division would like any extensions beyond June 30, 2024 to be drafted on the updated County long form contract boilerplate.

Performance Measures
Performance measures were included in Agreement No. 22-52 See Att. B. Performance Measures. These performance measures or similar performance measures will also be included in the renewal agreement.

County Counsel - review and approval of the Yolo County SMHS boilerplate
County Counsel - review and approval of the resulting renewal agreements as to form
Department of General Services, Procurement Division
CalMHSA - technical assistance with CalAIM Initiative

On or about July 20, 2021, the Yolo County Procurement Manager approved a sole source letter in conformance with the then current Yolo County Procurement Policy.