HomeMy WebLinkAboutAgenda Item.pdfBoard Agenda Item 35
DATE:November 17, 2015
TO:Board of Supervisors
SUBMITTED BY:Dawan Utecht, Director, Department of Behavioral Health
Robert W. Bash, Director of Internal Services/Chief Information Officer
SUBJECT:Agreement with Exodus Recovery, Inc.
RECOMMENDED ACTION(S):
1.Approve and authorize the Chairman to execute a retroactive Agreement with Exodus Recovery, Inc.,
for the ramp-up and implementation of the adult acute inpatient psychiatric health facility, effective
October 1, 2015 through June 30, 2016 ($2,048,296) (4/5 vote).
2.Approve and authorize the Chairman to execute an Agreement with Exodus Recovery, Inc., for the
operation of the adult acute inpatient psychiatric health facility, effective July 1, 2016, not to exceed
five consecutive years, which includes a three-year base contract and two optional one-year
extensions, total not to exceed $19,648,496.
3.Approve and authorize the Chairman to execute a Facility Use Agreement with Exodus Foundation,
Inc. effective January 1, 2016 through June 30, 2021, for County owned space at 4411 E. Kings
Canyon Rd, Fresno, CA 93702, Building 319 (14,318 square feet), to be used by Exodus Recovery,
Inc. to provide inpatient psychiatric health facility services to adults who may be admitted on a
voluntary or involuntary basis.
4.Adopt Resolution updating the designated mental health facilities authorized to provide psychiatric
evaluation and treatment services to individuals placed on an involuntary hold under the provisions
of California Welfare and Institutions Code 5150.
5.Authorize the Director of the Department of Behavioral Health or designee to modify the scope of
services and responsibilities of the contractor as needed, in regards to the Agreement with Exodus
Recovery, Inc. for acute inpatient psychiatric health facility services for adults.
6.Authorize the Director of the Department of Behavioral Health or designee to modify the budget line
items within the budgets, without exceeding the contract maximum in regards to the Agreement with
Exodus Recovery, Inc. for acute inpatient psychiatric health facility services for adults.
Approval of the recommended actions will allow for the ramp-up and implementation of the Adult Psychiatric
Health Facility (PHF) followed by a three-year base contract and two optional one-year service extensions for
acute inpatient care services for adults. Exodus Recovery, Inc. (Exodus) was selected following a Request for
Proposal (RFP) process. Exodus will begin acquiring all the necessary licensing and staff prior to
implementation on January 1, 2016, with no increase in net County cost. The current vendor, Crestwood
Behavioral, prior to ceasing operation of the Adult PHF on December 31, 2015, will work with Exodus to
transition the clients. The contract with Exodus for operation of the Adult PHF will replace janitorial and security
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services provided by County requiring, in accordance with Section 13 of the County Charter, a 4/5 vote by your
Board.
ALTERNATIVE ACTIONS:
The existing contract will expire on December 31, 2015. If the recommended actions are not approved, the
Department would be unable to provide mandated inpatient adult psychiatric services to County residents. Your
Board may direct the Department to assume operation of the Adult PHF to provide acute inpatient psychiatric
services; however, the decision will result in added costs to the County and a delay in services as the
Department obtains the required staff and licensure.
RETROACTIVE AGREEMENT:
The recommended Agreement is retroactive to October 1, 2015, to provide three months ramp-up time to
Exodus to complete the necessary hiring, staff training, State licensing, and other required implementation
activities to assume operation of the Adult PHF from the current vendor on January 1, 2016.
FISCAL IMPACT:
There is no increase in net County cost associated with the recommended actions. The maximum
compensation for the ramp-up and implementation phase from October 1, 2015 through June 30, 2016 is
$2,048,296. The recommended Agreement has provisions for a three-year base contract and two optional
one-year extensions through June 30, 2021, a total maximum compensation not to exceed $19,648,496. The
Agreement will be financed with Mental Health Realignment, Short/Doyle Medi-Cal Federal Financial
Participation and Behavioral Health Realignment funds. In addition, there is no cost associated with the Facility
Use Agreement for lease of County Building 319. The fair market value for leasing this space is estimated to be
$166,661 for a twelve-month period. This calculation is based on a monthly rental rate of $0.97 cents per
square foot. Fresno County, Internal Services Division, Lease Services was contacted and they concurred with
this rate. Over the term of the Agreement, the total value of the lease is estimated to be $916,638. Sufficient
appropriations and estimated revenues were included in the Department of Behavioral Health Org 5630 FY
2015-16 Adopted Budget and will be requested in the future budgets to cover the total anticipated cost of the
contract term.
DISCUSSION:
On May 14, 2015, the Department released a RFP for acute inpatient psychiatric services for adults which
closed on July 8, 2015. The evaluation panel consisting of staff from the Department of Behavioral Health, a
member of the Behavioral Health Board, and a representative from the Mental Health Patient’s Rights Advocacy
Program met on August 6, 2015, to evaluate the proposals received. The evaluation panel was able to reach
consensus with the recommendation of Exodus Recovery, Inc. (Exodus) for award of the contract. The panel
recommended Exodus for award based on the following:
·experience with operating PHFs;
·submission of a complete and strong bid;
·strong treatment component included within the bid;
·receptiveness to working with clients with co-occurring disorders; and,
·submission of a reasonable cost proposal.
The current contract for the Adult PHF operated by Crestwood Behavioral Health will terminate on December
31, 2015. The recommended Agreement with Exodus is proposed with an effective date of October 1, 2015, to
allow Exodus to effectively recruit and train staff before December 31, 2015, in order to ensure no service
disruption to the adult clients. The three-month period will also allow the current vendor and Exodus sufficient
time to transition clients, information, and services necessary for the operation of the Adult PHF with no
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disruption of services.
In accordance with California Code of Regulations (CCR), Title 22, the County is mandated to provide acute
inpatient psychiatric services to adult clients who are either a danger to themselves or others as stipulated within
California Welfare Institutions Code (W&IC), section 5150. Clients meeting these criteria may be admitted to
the Adult PHF on a voluntary or involuntary basis.
Through the recommended Agreement with Exodus, Adult PHF services will include:
·management of clients’ acute psychiatric disorders and preparation of clients to successfully utilize less
restrictive levels of care;
·clinical program services that are operational 24 hours, 7 days a week;
·comprehensive multi-disciplinary evaluation and treatment planning;
·dietary services;
·admission and discharge planning services, pharmaceutical services,
·physical health care;
·achieve co-occurring disorders capability; and,
·ensuring cultural and linguistic competence in the delivery of acute inpatient psychiatric services.
All acute inpatient psychiatric services will be in accordance with CCR Title 22, Division 5, Chapter 9.
Approval of the recommended Resolution will update your Board’s and the State approved W&IC 5150
designated mental health facilities in the County to meet State mandates to provide facilities with necessary staff
and equipment appropriate to respond to individuals experiencing a mental health crisis.
The recommended Agreement allows the Director to approve changes in line items within the budget that do not
result in any change to the maximum compensation amount and includes language for termination by Exodus
Recovery, County, or their designees upon the giving of 60 days advance written notice. Additional language
included allows for the termination of the Agreement due to non-allocation of funds upon the giving of 30 days
advance written notice to Exodus Recovery. The recommended Agreement will allow the Director or designee
the authority to modify the scope of services and responsibilities of the Agreement as necessary to be provided
by Exodus Recovery without modifying the maximum compensation and/or returning to your Board.
Approval of the recommended Facility Use Agreement with Exodus Foundation, Inc. (Exodus’ non-profit
organization) will allow these acute inpatient care services to be provided on County-owned property located at
4411 E Kings Canyon Rd in Fresno (14,318 square feet) and utilize private janitorial and security staff. There is
no cost to Exodus Foundation for use of the County-owned space. The fair market value for leasing this space
is estimated to be $166,661 for a twelve-month period and $916,638 over the term of the Agreement. The
Facilities Planning Committee discussed and approved the recommended Facility Use Agreement on
September 18, 2015.
Approval of the recommended Agreement, in accordance with Section 13 of the County Charter, will require a
4/5 vote by your Board. As of today’s date Crestwood Behavioral operates the Adult PHF with County janitorial
staff equivalent to 2.1 FTEs and security staff equivalent to 0.5 FTEs. All affected janitorial and security
positions will be reassigned to other areas of the County with available funding.
OTHER REVIEWING AGENCIES:
During the September 2015 meeting, the Behavioral Health Board was notified of the recommended Agreement
and actions.
REFERENCE MATERIAL:
BAI # 34, December 14, 2010
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ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with Exodus, Inc.
On file with Clerk - Resolution
On file with Clerk - Facilities Use Agreement
CAO ANALYST:
Sonia De La Rosa
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