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Home My WebLink AboutCCFMG BAI 46 A-23-298.pdf co Board Agenda Item 46 O 1856 O FRE`'� DATE: June 20, 2023 TO: Board of Supervisors SUBMITTED BY: Susan L. Holt, Director, Department of Behavioral Health SUBJECT: Agreements and Amendments to include State Mandated CalAIM Requirement Changes with Term Extensions RECOMMENDED ACTION(S). 1. Approve and Authorize the Chairman to execute the following agreements and amendments with various contractors for California Advancing and Innovating Medi-Cal requirement updates, all with one year and/or a possible 12-month term extensions with no payment structure changes necessary, all effective July 1, 2023: a. Amendment I to Agreement with Central Star Behavioral Health, Inc. for utilization of the County-owned property associated with operating the Crisis Residential Treatment Facility b. Amendment II to Agreement with Central California Faculty Medical Group for Psychiatry Services for Children and Adults c. Amendment I to Agreement with University Faculty Associates to utilize County facilities to provide Psychiatry Services d. Agreement with Community Health Improvement Partners for Independent Living Association Services e. Master Agreement with Various Providers for Temporary Staffing Services f. Amendment I to agreement with WestCare California, Inc. for Supervised Overnight Stay Program Services including Case Management g. Agreement with Kings View for Fresno Metro Crisis Intervention Treatment(CIT) Services h. Amendment I to Agreement with Kings View for a License Agreement for the Kings View Metro CIT Team to co-locate with DBH staff at the County's Health and Wellness Center i. Amendment II to Master Agreement with Various Providers for Locum Tenens Physician Services j. Amendment II to Master Agreement with Various Providers for Telemedicine Services k. Amendment I to Agreement with RH Community Builders for Short-Term Lodging Services Driven by Peer-Support Services. 2. Make a finding that it is in the best interest of the County to waive the competitive bidding process consistent with Administrative Policy No. 34 for unusual or extraordinary circumstances for a Master Agreement with various interested and qualified temporary staffing agencies for the Department to access a broader candidate pool. Approval of the recommended actions will allow the Department to adhere to new Department of Health Care Services (DHCS) implemented California Advancing and Innovating Medi-Cal (CaIAIM) regulations throughout the Behavioral Health System of Care. The applicable agreements require a term extension for one year and/or a possible 12-month extension based upon satisfactory performance in order to allow the County of Fresno Page 1 File Number:23-0528 File Number:23-0528 Department time to appropriately analyze the impacts of the new CalAIM changes to the County and the subcontracted providers. The first recommended action, via some supersede agreements and some amendments, will allow for necessary updates to agreement language for existing contracts to align with CalAIM requirements necessitating a term extension. The recommended actions will become effective on July 1, 2023, with no increase in Net County Cost. This item is county-wide. ALTERNATIVE ACTION(S): There are no viable alternative actions. Should your Board not approve the recommended action, existing individuals served by expiring contracts will experience a gap in services and/or the County will not be compliant with new CalAIM regulations required of all subcontracted providers within the Behavioral Health System of Care. If contracts expire, the Department of Behavioral Health (Department)would be left without a provider network to serve the community; the Department has insufficient clinical staff to provide these services due to an approximately 30% vacancy rate and therefore could not absorb the population in county-operated without gaps in services. SUSPENSION OF COMPETITION: The Agreement to update County Agreement No. 18-666 for a Master Agreement with various temporary employment agencies to provide temporary clinical and clerical staff, as needed within the Department, requires a Suspension of Competition. The Master Agreement is with any and all interested and qualified agencies, with no financial commitment. Each will be given the same and equal access to recruitment announcements. This assists the Department by providing a broader candidate pool. The Internal Services Division - Purchasing concurs with the Department's request to suspend the competitive bidding process. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. Attachment A includes the FY 2023-24 contract amounts, the maximum compensation amounts, and funding sources of each contract included herein. Each of the contracts identified within the Attachment will be fully funded by their existing funding sources including, but not limited to: Medi-Cal Federal Financial Participation, Mental Health Realignment funds, and Mental Health Services Act funds (Community Services and Supports and/or Prevention and Early Intervention). Sufficient appropriations and estimated revenues are included in the Department's Org 5630 FY 2023-24 Recommended Budget and will be included in all future recommended budgets throughout the remainder of the contract terms. DISCUSSION: CalAIM is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory. The three goals of CalAIM are: 1) identify and manage comprehensive needs through whole person care approaches and social drivers or health, 2) improve quality outcomes, reduced health disparities, and transform the delivery system through value-based initiatives, modernization, and payment reform, and 3) make Medi-Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility. Under the CalAIM transformation effort, the County is required to update contracts with new language to include the new CalAIM related requirements to ensure compliance. The recommended supersede agreements and amendments have updated contract language that ensures compliance with the new CalAIM requirements and will maintain the current service levels provided to the individuals served throughout the Behavioral Health System of Care. The following agreements will assimilate the contracted providers to the new CalAIM requirement changes including a requested term extension. County of Fresno Page 2 File Number.23-0528 File Number:23-0528 • Attachment A includes information for 11 contracts requiring a one-year term extension and/or an option for another 12-month extension based on satisfactory performance and to modify current contract language regarding CalAIM requirements and includes: contractor name, services provided, Board agreement#(including any related amendments), and maximum compensation for FY 2023- 24. Several agreements within the first recommended action include additional language within the modification clause of the agreements that allows the DBH Director, or designee, the authority to make changes to the agreement in order to accommodate changes in the law and/or to increase the rates during the course of the agreement(s). Additionally, the Master Agreements within the first recommended action also include language that grants authority to the DBH Director, or designee, to terminate the agreements with individual providers with mutual consent of the DBH Director and the Contractor. The requested agreements and amendments will become effective July 1, 2023. OTHER REVIEWING AGENCIES: The Behavioral Health Board was informed of this agenda item and related agreements and amendments at the May 17, 2023 meeting. REFERENCE MATERIAL: BAI #35, February 28, 2023 BAI #36, February 28, 2023 BAI #26, September 20, 2022 BAI #17, January 18, 2022 BAI #56, December 15, 2020 BAI #27, February 4, 2020 BAI #23, January 7, 2020 BAI #48, May 7, 2019 BAI #30, December 11, 2018 BAI #32, December 11, 2018 BAI #38, December 4, 2018 BAI #35, September 25, 2018 BAI #13, May 1, 2018 BAI #13, May 1, 2018 BAI #34, November 14, 2017 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk-Amendment I to Agreement with CSBH On file with Clerk-Amendment 11 to Agreements with CCFMG On file with Clerk-Amendment I to Agreement with UFA On file with Clerk-Agreement with CHIP On file with Clerk- Master Agreement On file with Clerk-Amendment I to Agreement with WCC On file with Clerk-Agreement with Kings View On file with Clerk-Amendment I to Agreement with Kings View On file with Clerk-Amendment I I to Master Agreement for Locum Tenens On file with Clerk-Amendment 11 to Master Agreement for Telemedicine On file with Clerk-Amendment I to Agreement with RHCB Suspension of Competition County of Fresno Page 3 File Number.23-0528 File Number:23-0528 Attachment A CAO ANALYST: Ronald Alexander County of Fresno Page 4 File Number:23-0528