Approve fifth amendment to Agreement No. 5151 with Brighter Horizon Group Homes, Inc. to add funding in the amount of $329,000 for fiscal year (FY) 2024-25 for a new contract maximum of $979,000, for the period of July 1, 2023 through June 30, 2026, for the provision of Short Term Residential Therapeutic Program (STRTP) services. Implementation of AB1051, which requires STRTPs to enter into individual contracts with each placing county, created administrative challenges for the contractor in submitting timely claims. The FY 2024-25 funds associated with these services were accured; therefore, this amendment results in no net budget impact to the County. (No general fund impact) (Morales)

Brighter Horizon Group Homes, Inc. (Brighter Horizon) operates a Short-Term Residential Treatment Program (STRTP) for youth who require Child Welfare or Probation residential placement and provides Specialty Mental Health Services (SMHS). When the need for placement in a STRTP occurs, it often involves youth who have an urgent and immediate need for placement, which is difficult to plan for in advance. This challenge is intensified by the limited availability of STRTP facilities statewide. To address these challenges, Yolo County contracts with STRTP facilities in the local and surrounding area as well as any facilities where placement is likely to ensure access to STRTP placements as soon as possible. Brighter Horizon is one such provider that offers SMHS and meets the needs of youth in Yolo County.

On or about October 5, 2023, the County and Brighter Horizon (the Parties) entered into Agreement No. 5151 (the Agreement) with an initial term of July 1, 2023 through June 30, 2024 and a contract maximum of $100,000. On or about March 12, 2024, the Parties amended the Agreement (first amendment) to add additional funding in the amount of $200,000 for FY 2023-24. On or about May 7, 2024, the Parties further amended the Agreement (second amendment) to extend the term of the agreement through June 30, 2025; and added funding in the amount of $100,000 for 2024-25. On or about June 24, 2025, the Parties further amended the Agreement (third amendment) to extend the term of the agreement through June 30, 2026; and added funding in the amount of $250,000 for 2025-26. On or about September 24, 2025, the Parties further amended the Agreement (fourth amendment) to update rates for 2025-26.

This fifth amendment adds funding in the amount of $329,000 for FY 2024-25. This additional funding is needed to pay outstanding claims for FY 2024-25 based on the number of youth placed in Brighter Horizon. During FY 2024-25, Brighter Horizons experienced challenges with submitting their claims timely. One challenge has been AB1051 which requires STRTP facilities to contract individually with every placing county, rather than using the previously allowed presumptive transfer process. This created a sizeable administrative burden on all STRTP facilities, including Brighter Horizons. Additionally, as a small agency, they have limited administrative support which resulted in delays with claim submission and working on resubmission of claims after Medi-Cal denials.  HHSA is working with Brighter Horizons to ensure a smooth process for submitting claims and working denials to ensure all claims get submitted and paid in a timely manner going forward. HHSA has been working with Brighter Horizon on their billing and recently received the final numbers of the amount owed to Brighter Horizon for FY 2024-25. The services provided by Brighter Horizons to children in placement are mandated specialty mental health services.

County Counsel has approved this amendment as to form
General Services Department, Procurement Division

On or about March 15, 2024, the Yolo County Deputy Director/Manager of Procurement approved a sole source letter in conformance with the updated Yolo County Procurement Policy with Brighter Horizon Group Homes, Inc. to provide Short Term Residential Therapeutic Program (STRTP) services.

Procurement reviewed HHSA’s request and determined that it was in the best interest of the County to approve the sole source. Without sole source approval, the County would lose the ability to place Child Welfare or Probation youth into an STRTP facility timely. Factors considered included, but were not limited to: 1) urgent and immediate placement needs for youth into an STRTP facility that provides specialty mental health services; 2) Vendor’s status as an STRTP facility that provides the needed services in the local and surrounding area that typically has availability for placement; 3) Vendor rates being fair compared to other STRTP facilities in the surrounding areas; and 4) the County would be limited or lose the ability to place youth into an appropriate STRTP facility that is able to meet the specific mental health needs of the youth.

Vendor Performance:
The Performance Measures were included in the underlying Agreement and are not being revised at this time. 

HHSA confirms Brighter Horizon is performing satisfactorily under this Agreement. Brighter Horizon has provided care to the most vulnerable Child Welfare or Probation clients and have been instrumental in meeting the needs of youth in Yolo County by ensuring access to STRTP placements as soon as possible. Yolo County is the Mental Health Plan associated with Brighter Horizon and has a responsibility to ensure that all youth placed in the STRTP can access Specialty Mental Health Services (SMHS) during their placement. Yolo County meets with Brighter Horizon on an at least monthly basis to address compliance and review treatment progress, often with Child Welfare and Probation in attendance. The provider has been responsive to feedback and remains committed to delivering quality care. Child Welfare and Probation agencies statewide continue to place youth in their facilities. Brighter Horizon provides mental health services to youth needing this level of care and has been a collaborative partner in ensuring child welfare and probation youth receive quality services while in the STRTP placement.

% of unduplicated youth served: < 11

% of unduplicated youth with a stay longer than 6 months:   38%

For context, not all youth were placed in the placement long enough in the fiscal year to be ready for discharge. Additionally, other factors contribute to youth stepping down, such as the identification of the step down by the placing agency, and the significant preparation that can occur to ensure the step down is successful.
 

% of Productivity maintained by provider (Clinicians, Case managers, Psychiatrist) Minimum 51%
 

In contrast, youth in E.P.S.D.T (traditional outpatient) services receive between 5 and 10 billable services per month.
 

% of Youth who did not require psychiatric hospitalization during their treatment:    50%

Included in the other 50% are youth that required a crisis intervention or were at the Emergency Room due to his psychiatric concerns, may not have been psychiatrically hospitalized.