Approve first amendment to Agreement No. 25-228 with Crestwood Behavioral Health Inc. to decrease funding in the amount of $2,517,500 for a new contract maximum of $6,482,500, for the period of July 1, 2025 through June 30, 2028 and approve a 4% increase to the rates effective July 1, 2026, for the provision of 24-hour, long term mental health residential and rehabilitative services for Seriously Mental Ill (SMI) adults. (General fund impact $636,859.00) (Morales)

Approve first amendment to Agreement No. 25-228 with Crestwood Behavioral Health Inc. to decrease funding in the amount of $2,517,500  for a new contract maximum of $6,482,500, for the period of July 1, 2025 through June 30,2028 and approve a 4% increase to the rates effective July 1, 2026, for the provision of 24-hour, long term mental health residential and rehabilitative services for Seriously Mental Ill (SMI) adults.

On October 21, 2025, the County and Crestwood Behavioral Health entered into an agreement to operate a 24-hour long-term inpatient psychiatric care for adult psychiatric consumers who are conserved by the Public Guardian and who are deemed gravely disabled due to a mental health condition. Many of our most fragile consumers cannot be placed in homes or facilities that offer lower levels of care because they need the clinical and nursing support provided in long-term inpatient psychiatric facilities.
Services under this Agreement shall be provided across various service locations and facilities, including:

HHSA is requesting approval of this first amendment to reduce funding by $2,517,500 by reducing $1,304,500 for 2025-26; $606,500 for 2026-27 and $606,500 for 2027-28. The contract decreases for 2025-26 is due to lower utilization of this Agreement and the need to shift funding to higher utilized contract providers. The reduced funding for 2026-27 is to align with the recommended budget amount. This amendment also increases rates for FY 2026-27. The rate increase is needed to adjust the increase in the cost of providing services. The requested rate increase reflects significant changes in client needs, service expectations, and driving increased market wages for staff due to shortages of behavioral health professions. Client acuity has increased due to the implementation of SB43, which expands the complexity of individuals requiring behavioral health services. Per Minute Order 25-35, dated May 20, 2025, the Board approved to allow the HHSA Director to sign amendment(s) for rate increases as long as the increase did not exceed four percent (4%). This rate increase for 2026-27 exceeds four percent (4%) from their 2025-26 rates, please see (Att. A. First Amendment) to review the rate tables.

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

On April 22, 2025, 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. Without a sole/single source approval for these services, County would be negatively impacted, including County’s ability to place consumers in the numerous facilities Crestwood offers throughout the State. Factors considered included but were not limited to: 1. Fair pricing based on facility type; 2. no other providers offer the range of facilities and levels of care throughout the State that Crestwood offers.

2024-25 Performance Data
# of Yolo County clients served in a Crestwood Facility: 128
Total # of bed days utilized by Yolo County Clients: 8858
Average length of Yolo County clients stay (in days) at facility in the past year: 69
% of Yolo County Clients who returned to the community within 6 months of facility admission: 5%
% of Yolo County Clients who returned to the community within 12 months of facility admission: 18%
% of Yolo County clients discharged from the facility to a lower level of care from the facility in the last Year: 7%
% of Yolo County Clients who experience one or fewer acute psychiatric hospital stays during the placement at the facility in the last year: 0

2025-26 Performance Data Q1-Q3
# of Yolo County clients served in a Crestwood Facility: 72
Total # of bed days utilized by Yolo County Clients: 5998
Average length of Yolo County clients stay (in days) at facility in the past year: 83
% of Yolo County Clients who returned to the community within 6 months of facility admission: 10%
% of Yolo County Clients who returned to the community within 12 months of facility admission: 8%
% of Yolo County clients discharged from the facility to a lower level of care from the facility in the last Year: 4%
% of Yolo County Clients who experience one or fewer acute psychiatric hospital stays during the placement at the facility in the last year: 0