Approve sixth amendment to Agreement No. 19-230 with BHC Sierra Vista Hospital to add funding in the amount of $221,600 for 2022-23 for a new contract maximum of $2,626,250 for the period of July 1, 2019 through June 30, 2024; and update language, for the provision of Acute Psychiatric Inpatient Services. (No general fund impact) (Sullivan)

Approve sixth amendment to Agreement No. 19-230 with BHC Sierra Vista Hospital to add funding in the amount of $221,600 for 2022-23 for a new contract maximum of $2,626,250 for the period of July 1, 2019 through June 30, 2024; and update language, for the provision 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 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 services, the patient must be treated by another qualified psychiatric hospital facility in the surrounding area.  BHC Sierra Vista Hospital, 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 service provider for this population is not paid directly via the County.  The service provider 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 November 5, 2019, the County entered into an Agreement with BHC Sierra Vista Hospital with an initial term of July 1, 2019 through June 30, 2022 with a contract maximum of $1,410,000. The Agreement also included 2 optional extensions for FY 2022-23 and 2023-24.

On or about January 12, 2021, the Parties amended the Agreement via the first amendment to reduce funding in the amount of $120,000 for FY 2020-21 and $120,000 for FY 2021-22 for a new contract maximum of $1,170,000.

On or about June 29, 2021, the Parties further amended the Agreement via the second amendment to add funding in the amount of $150,000 for FY 2020-21 for a new contract maximum of $1,320,000.

On or about October 26, 2021, the Parties further amended the Agreement via the third amendment to add funding in the amount of $70,000 for FY 2020-21 for a new contract maximum of $1,390,000.

On or about March 24, 2022, the County exercised the option to extend the Agreement through FY 2022-23 under the same terms and conditions and added $400,000 for FY 2022-23.

On or about June 7, 2022, the Parties further amended to the Agreement via the fourth amendment to add funding in the amount of $82,000 for FY 2020-21 and $70,000 for FY 2021-22 for a new contract maximum of $1,942,000.

On or about January 10, 2023, the Parties further amended the Agreement via the fifth amendment to add funding in the amount of $62,650 for FY 2021-22 for a new contract maximum of $2,004,650 and to update contract language.

On or about June 7, 2023, the County exercised the option to extend the Agreement through FY 2023-24 under the same terms and conditions and added $400,000 for FY 2023-24.

Approval of this sixth amendment is necessary to cover the remaining claims for FY 2022-23.  Additional annual funding as of FY 2022-23 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 Sierra Vista Hospital has performed satisfactorily under this agreement. Provider has served 27 unduplicated clients and provided them 369 services in FY2223. The average time of stay for the clients was 12.3 days. 100% of clients did not experience a psychiatric re-admission within 7 days of discharge, and 100% of clients did not experience a psychiatric re-admission within 30 days of discharge.

County Counsel has approved this Agreement as to form.

 

This agreement was sought through a Sole Source, which has been approved by Procurement Manager on May 2,2019.

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.