HomeMy WebLinkAboutCombined BAI and A-22-506 with JDT Consultants.pdf COZj���C
Board Agenda Item 24
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DATE: November 8, 2022
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment I to Agreement No. 18-699 with JDT Consultants, Inc. for
Therapeutic Behavioral Services
RECOMMENDED ACTION(S):
Approve and authorize the Chairman to execute Amendment I to Agreement with JDT Consultants,
Inc.for an increase in service rates for the Therapeutic Behavioral Services program, effective
upon execution with no change to the term of January 1, 2019 through June 30, 2023 or the
maximum compensation of$18,300,000.
Approval of the recommended action would allow the vendor to increase their service rates and salaries to
align with industry trends and minimize staff turnover. The vendor has experienced high turnover rates, due
to lower salaries, which has impacted their ability to provide quality and timely services. The recommended
amendment would allow for an increase in per minute rates, with no increase to the overall compensation or
Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
There is no alternative action. Should your Board not approve the recommended action, the vendor will
continue with the currently contracted rates and salaries. Services may continue to experience high staff
turnover rates and the timely delivery of crucial Therapeutic Behavioral Services to local high acuity youth
will continue to be impacted.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. The recommended
agreement($18,300,000)and recommended amendment will be fully funded with Medi-Cal Federal
Financial Participation (FFP), Behavioral Health Realignment, and Mental Health Realignment. Sufficient
appropriations and estimated revenues are included in the Behavioral Health Org 5630 FY 2022-23 Adopted
Budget. Approval of the recommended action will not increase the maximum compensation.
DISCUSSION:
On December 11, 2018, the Board approved Agreement No. 18-699 with JDT Consultants, for the provision
of Therapeutic Behavioral Services (TBS)for the Department. The program provides one-to-one therapeutic
contacts between a mental health specialist and youth who meet the program criteria and their families.
TBS focus on behaviors and symptoms, which may jeopardize existing placements, or act as barriers to a
lower level of residential placement or the completion of specific treatment goals. The TBS coach meets
with clients at their home, school, or a place where the client is most comfortable, during times most
therapeutic and when interventions are most needed.
County of Fresno page 1 File Number.22-1093
File Number:22-1093
JDT has experienced a high staff turnover rate for this program, impacting the ability to provide timely
access to treatment services. Clinicians are hired and trained on a regular basis; however, JDT has
experienced a trend of trained clinicians leaving to organizations that can compensate at a higher rate.
Turnover impacts JDT' s allocated training budget, as more funds are constantly needed to keep up with the
demand of new hire trainings.
Additionally, JDT staff have experienced an increase in caseload ratios, as well as an increase in client
acuity and clients in rural areas, which creates larger workloads for staff of this program. JDT has also
experienced an increase in operational costs, including increases in rent, utilities, staff development costs,
and staff mileage, largely due to inflation, since the beginning of this contract. The current service rate for
TBS services is set at$2.00 per minute; this rate has not changed in 18 years, which has hindered JDT's
ability to account for rising costs of every kind. This rate increase to $2.30 per minute would help bring both
the service rates and salaries to align with industry trends.
With your Board's approval, the recommended amendment would result in an increase to the per minute
rates and allow an increase to salaries and retain vendor staff. The program has a base contract term of
three years with the option of two additional one-year renewals. The recommended action would increase
the rate for FY 2022-23, upon execution, with no changes to the agreement terms and no increase to the
maximum compensation.
REFERENCE MATERIAL:
BAI #36, December 11, 2018
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk-Amendment I to Agreement No. 18-699 with JDT
CAO ANALYST:
Ronald Alexander
County of Fresno page 2 File Number.22-1093
Agreement No. 22-506
1 AMENDMENT NO. 1 TO SERVICE AGREEMENT
2 This Amendment No. 1 to Service Agreement ("Amendment No. 1") is dated
3 November 8, 2022 and is between JDT Consultants, Inc., a California for-Profit
4 Corporation ("Contractor"), and the County of Fresno, a political subdivision of the State of
5 California ("County").
6 Recitals
7 A. On December 11, 2018, the County and the Contractor entered into an Agreement with
8 JDT Consultants, Inc. for the Therapeutic Behavioral Services (TBS) Program, which is County
9 agreement number A-18-699 ("Agreement"), for the provision of therapeutic behavioral services
10 to Fresno County Medi-Cal Beneficiaries as mandated pursuant to the permanent injunction
11 issued by the United States District Court in the case of Emily Q. v. Bonta, (C.D. Cal. 2001) 208
12 F.Supp.2d 1078.
13 B. On August 10, 2022, Contractor requested an increase of their program rates, citing
14 increased referral numbers due to rising client acuity as the primary reasons for requesting the
15 increase, staff retention issues due to non-competitive staff salaries, and rising costs of rent,
16 utilities, and other resources. The Department of Behavioral Health reviewed this request and
17 recommended the County and the Contractor move forward with an Amendment to the original
18 agreement, per the Modification section of the current agreement.
19 C. The County and the Contractor now desire to amend the Agreement to modify the
20 compensation rates and modification language within this Agreement.
21 The parties therefore agree as follows:
22 1. Subsection 5.0 of the Agreement located at page 6, beginning on line 4, with the
23 number 1" and ending on page 6, line 7 with the word "note" is deleted in its entirety and
24 replaced with the following:
25 111. For the period of January 1, 2019 through November 7, 2022, COUNTY
26 agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
27 compensation for providing TBS at a rate of Two and No/100 dollars ($2.00) per
28 minute for actual time provided to Members within and outside of Fresno County
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1 up to the amount of time authorized by COUNTY and documented in the TBS
2 progress note.
3 For the period of November 8, 2022 through June 30, 2023, COUNTY agrees to
4 pay CONTRACTOR and CONTRACTOR agrees to receive compensation for
5 providing TBS at a rate of Two and 30/100 dollars ($2.30) per minute for actual
6 time provided to Members within and outside of Fresno County up to the amount
7 of time authorized by COUNTY and documented in the TBS progress note."
8 2. When both parties have signed this Amendment No. 1, the Agreement, and this
9 Amendment No. 1 together constitute the Agreement.
10 3. The Contractor represents and warrants to the County that:
11 a. The Contractor is duly authorized and empowered to sign and perform its obligations
12 under this Amendment.
13 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
14 to do so and his or her signature on this Amendment legally binds the Contractor to
15 the terms of this Amendment.
16 4. The parties agree that this Amendment may be executed by electronic signature as
17 provided in this section.
18 a. An "electronic signature" means any symbol or process intended by an individual
19 signing this Amendment to represent their signature, including but not limited to (1) a
20 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
21 electronically scanned and transmitted (for example by PDF document) version of an
22 original handwritten signature.
23 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
24 equivalent to a valid original handwritten signature of the person signing this
25 Amendment for all purposes, including but not limited to evidentiary proof in any
26 administrative or judicial proceeding, and (2) has the same force and effect as the
27 valid original handwritten signature of that person.
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1 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
2 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
3 2, Title 2.5, beginning with section 1633.1).
4 d. Each party using a digital signature represents that it has undertaken and satisfied
5 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
6 through (5), and agrees that each other party may rely upon that representation.
7 e. This Amendment is not conditioned upon the parties conducting the transactions
8 under it by electronic means and either party may sign this Amendment with an
9 original handwritten signature.
10 5. This Amendment may be signed in counterparts, each of which is an original, and all of
11 which together constitute this Amendment.
12 6. The Agreement as amended by this Amendment No. 1 is ratified and continued. All
13 provisions of the Agreement and not amended by this Amendment No. 1 remain in full force and
14 effect.
15 [SIGNATURE PAGE FOLLOWS]
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I The parties are signing this Amendment No. 1 on the date stated in the introductory
2 clause.
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JDT ultants, Inc. COUNTY OF FRESNO
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6 an d , President Brian Pacheco, Chairman of the Board of
Supervisors of the County of Fresno
7 4205 W. 'garden Drive
Fresno, CA 93722 Attest:
8 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
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By:
11 Deputy
12 For accounting use only:
13 Org No.: 56302666
Account No.: 7295
14 Fund No.: 0001
Subclass No.: 10000
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