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Board Agenda Item 46
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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
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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.
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• 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
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Attachment A
CAO ANALYST:
Ronald Alexander
County of Fresno Page 4 File Number:23-0528