Approve fourth amendment to Agreement No. 23-149 with North Valley Behavioral Health to extend the term through June 30, 2026 and add funding in the amount of $4,750,232 by adding $1,374,716 for 2024-25, and adding $3,375,516 for 2025-26 for a new contract maximum of $10,628,302 for the period of July 1, 2023 through June 30, 2026 for the provision of Adult Inpatient Psychiatric Health Facility Services. (No general fund impact) (Sullivan)

Approve fourth amendment to Agreement No. 23-149 with North Valley Behavioral Health to extend the term through June 30, 2026 and add funding in the amount of $4,750,232 by adding $1,374,716 for 2024-25, and adding $3,375,516 for 2025-26 for a new contract maximum of $10,628,302 for the period of July 1, 2023 through June 30, 2026 for the provision of Adult Inpatient Psychiatric Health Facility Services. 

As the local Mental Health Plan, the County is mandated to provide psychiatric health facility (PHF) services to eligible consumers with serious mental illness (SMI). North Valley Behavioral Health operates two multidisciplinary inpatient psychiatric health facilities. Their programs offer a patient-centered, “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 SMI who are deemed in need of the highest level of care provided in a non-state (local) hospital like facility.

On July 20, 2021, the County and North Valley Behavioral Health entered into Agreement No. 21-140 for the provision of psychiatric health facility (PHF) services. Agreement No. 21-140 was terminated and replaced in its entirety with Agreement No. 23-149, effective July 1, 2023. This was due to a change in programmatic regulatory requirements and updated billing/claiming requirements under the California Department of Healthcare Services CalAIM payment reform initiative. Subsequently, Agreement No. 23-149 has been amended several times to meet business needs as follows: on or about February 27, 2024, it was amended to add funding in the amount of $1,605,950 for 2023-24 to meet the needs of current clients and projected utilization through the fiscal year. On or about June 4, 2024, it was amended to extend the term through June 30, 2025, add funding in the amount of $2,000,800, and add facility rates for 2024-25. Lastly, on or about September 10, 2024, it was amended to add funding in the amount of $22,532 to cover remaining mandated services provided in 2023-24.

Now, approval of this fourth amendment will allow for additional funding for 2024-25 and extend services and funding through June 30, 2026. The additional funding is based on projections and the County’s spenddown report, as well as increased client costs.

County Counsel has approved the Amendment as to form.
General Services Department, Procurement Division.

On or about July 20, 2021, the then acting County’s Deputy Director of GSD/Manager of Procurement/County Purchasing Agent (Purchasing Agent) approved a sole/single source procurement for these services, based on satisfactory service/reasonable prices and to avoid the interruption of County business. The sole source was approved to cover a term through 2025-26. Without sole/single source approval for these services, the County would not have the much-needed dedicated beds to provide mandated services to meet the crisis needs of its residents. North Valley Behavioral Health offers client-centered, accessible, comprehensive, quality, and affordable inpatient psychiatric service center that can be available to the County without wait times. North Valley Behavioral Health is the only local provider of psychiatric health facility services that can accommodate HHSA’s need for six (6) dedicated beds. The price of each contracted bed is reasonable, and the bed costs are Medi-Cal reimbursable.

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

HHSA is satisfied with North Valley Behavioral Health performance under Agreement No. 23-149. In 2023-24 the provider served 50 clients with the medium length of stay of 22 days. The re-admittance rate at this facility was 4% or 2 out of 50 clients re-admitted to this facility within 7 days of discharge and 91% of clients did not re-admit to any inpatient facility within 30 days of discharge from this facility.