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HomeMy WebLinkAboutAgreement A-24-474 Amendment IV to Master Agreement.pdf Agreement No. 24-474 1 AMENDMENT IV TO AGREEMENT 2 THIS AMENDMENT, hereinafter referred to as Amendment IV, is made and entered into 3 this 10th day of September , 2024 by and between the COUNTY OF FRESNO, a Political 4 Subdivision of the State of California, hereinafter referred to as "COUNTY', and each CONTRACTOR 5 listed in Exhibit A-1-1 "List of Contractors" attached hereto and incorporated herein by reference, and 6 collectively hereinafter referred to as "CONTRACTOR(S)", and such additional CONTRACTOR(S) as 7 may, from time to time during the term of this Agreement, be added or deleted by COUNTY. 8 Reference in this Agreement to party or"parties" shall be understood to refer to COUNTY and each 9 individual CONTRACTOR(S), unless otherwise specified. 10 WITNESSETH 11 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement 12 No. A-21-258, effective July 1, 2021, as amended by COUNTY Agreement No. A-23-059 effective 13 February 7, 2023, COUNTY Agreement No. A-23-315 effective July 1, 2023, and COUNTY 14 Agreement No. A-24-368 effective June 3, 2024, collectively COUNTY Agreement No. A-21-258, 15 whereby, CONTRACTORS agreed to provide geropsychiatric skilled nursing care, locked skilled 16 nursing care with special mental health treatment programs, mental health rehabilitation center 17 services, ancillary services and other enhanced treatment services and other facilities to house and 18 treat adults with severe and serious mental health impairments; and 19 WHEREAS, each CONTRACTOR has the secured facilities, staff and expertise, and is 20 licensed by the State of California, to provide residential mental health services and ancillary services 21 to severely and persistently mentally disabled persons in appropriate skilled nursing or mental health 22 rehabilitation center facilities; and 23 WHEREAS, COUNTY now desires to amend the description of services and rates to modify 24 the bed hold language for Contractor 7th Avenue Center, LLC and Contractor Mental Health 25 Management 1, Inc., d.b.a. Canyon Manor to expand the permissions for the placement of a bed hold 26 to include both psychiatric and non-psychiatric reasons, and amend the description of services and 27 rates to add a bed hold rate for Contractor Helios Healthcare, LLC, d.b.a. Idylwood Care Center and 28 Contractor Mental Health Management I, Inc., d.b.a. Canyon Manor; and -1 - COUNTY OF FRESNO Fresno, CA 1 WHEREAS, the parties desire to amend COUNTY Agreement No. A-21-258 regarding changes 2 as stated below. 3 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is 4 hereby acknowledged, the parties agree as follows: 5 1. All references to Revised Exhibit A shall be deemed references to Exhibit A-1-1. Exhibit 6 A-1-1 is attached and incorporated by this reference. 7 2. All references to Revised Exhibit C-1 "DESCRIPTION OF SERVICES & RATES" for 71' 8 Avenue Center, LLC shall be deemed references to Exhibit C-1-1. 9 3. All references to Revised Exhibit C-5 "DESCRIPTION OF SERVICES & RATES" for 10 Helios Healthcare, LLC, d.b.a. Idylwood Care Center shall be deemed references to Exhibit C-5-1. 11 4. All references to Revised Exhibit C-8 "DESCRIPTION OF SERVICES & RATES" for 12 Mental Health Management 1, Inc., d.b.a. Canyon Manor shall be deemed references to Exhibit C-8-1 13 5. The parties agree that this Amendment IV is sufficient to amend the Agreement; and that 14 upon execution of this Amendment IV, the Agreement, Amendment I, Amendment 11, Amendment III, 15 and Amendment IV together shall be considered the Agreement. 16 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 17 covenants, conditions, and promises contained in the Agreement and not amended herein shall remain 18 in full force and in effect. This amendment is effective upon execution. 19 [SIGNATURE PAGE FOLLOWS] 20 21 22 23 24 25 26 27 28 -2- COUNTY OFFRESNO Fresno, CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment IV to Agreement No. 2 A-21-258 as of the day and year first hereinabove written. 3 4 CONTRACTOR(S): COUNTY OF FRESNO 5 PLEASE SEE SIGNATURE r PAGES ATTACHED 6 Nathan Magsig, Chairman of the Board of 7 Supervisors of the County of Fresno 8 9 ATTEST: 10 Bernice E. Seidel Clerk of the Board of Supervisors 11 County of Fresno, State of California 12 By: 13 Deputy 14 15 16 17 18 FOR ACCOUNTING USE ONLY: Fund/Subclass: 0001/10000 19 Organization: 56302175 Account/Program: 7295/0 20 21 $133,577,211 Term Maximum 22 $21,879,610 FY 2021-22 $24,067,571 FY 2022-23 23 $26,474,329 FY 2023-24 $29,121,762 FY 2024-25 24 $32,033,939 FY 2025-26 25 26 27 28 -3- COUNTY OFFRESNO Fresno,CA I IN WITNESS WHEREOF, the parties hereto have executed this Amendment IV to Agreement No. 2 A-21-258 as of the day and year first hereinabove written. 3 CONTRACTOR: 71h Avenue Center, LLC 4 5 R y_ 6 7 Print Name: L 8 Title: /w 9 Chairman of the8 ard, President, or Vice President 10 Date: 11 12 13 Bey 14 15 Print Nam 16 r� 17 Title: ��n�c—C e71✓'� Secretary (of Corporation), Assistant S(Oretary, 18 Chief Financial Officer, or Assistant Treasurer 19 Date: 71 20 21 22 MAILING ADDRESS: 23 2115 7th Avenue 24 Santa Cruz, CA 95062 25 26 27 28 -4- COUNTY OF FRESNO Fresno,CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment IV to Agreement No. 2 A-21-258 as of the day and year first hereinabove written. 3 CONTRACTOR: Helios Healthcare, LLC, d.b.a. Idylwood Care Center 4 5 By 6 7 Print Name: Elena Mashkevich 8 Title: Executive Director of Contracts 9 Chairman of the Board, President, or Vice President 10 11 Date: 7/26/2024 12 13 By 14 15 Print Name: Maria Stefanou 16 17 Title: Chief Financial Officer Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 Date: July 29, 2024 20 21 22 MAILING ADDRESS: 23 1002 West Fremont Avenue 24 Sunnyvale, CA 94087 25 26 27 28 -5- COUNTY OFFRESNO Fresno, CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment IV to Agreement No. 2 A-21-258 as of the day and year first hereinabove written, 3 CONTRACTOR: Mental Health Management I, Inc., d.b.a. Canyon Manor 4 6 ' t 7 Print Name: r- $ �- Title: 9 Chairman of the Board, President, or Vice President 10 11 Date: --I / a,k-.V 12 13 �� By 14 15 Print Name: 9F-L4C L W I c-Mb7-(— 16 17 Title: Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 Date: 20 21 22 MAILING ADDRESS: 23 655 Canyon Manor Road 24 Novato, CA 94947 25 26 27 28 -6- COUNTY OFFRESNO Fresno,CA Exhibit A-1-1 LIST OF CONTRACTORS CONTRACTOR NAME EXHIBIT REFERENCE 1. 71" Avenue Center Exhibit C-1-1 2. CF Merced Behavioral, LLC., d.b.a. Merced Behavioral Exhibit C-2-1 Center 3. Crestwood Behavioral Health, Inc. Revised Exhibit C-3 4. Vista Pacifica Enterprises, Inc., d.b.a. Vista Pacifica Revised Exhibit C-4 (a-b) Center and d.b.a. Vista Pacifica Convalescent 5. Helios Healthcare, LLC., d.b.a. Idylwood Care Center Exhibit C-5-1 6. KF Community Care, LLC., d.b.a. Community Care Center Revised Exhibit C-6 7. Telecare Corporation Revised Exhibit C-7 (a-c) 8. Mental Health Management I, Inc., d.b.a. Canyon Manor Exhibit C-8-1 9. Oaklandidence Opco, LLC., d.b.a. Medical Hill Healthcare Revised Exhibit C-9 Center 10. Community Care on Palm Riverside, LLC Revised Exhibit C-10 11. California Psychiatric Transitions Revised Exhibit C-11 12. Golden State Health Centers, Inc., d.b.a. Sylmar Health and Rehabilitation Center Revised Exhibit C-12 13. Countryside Care Center, LLC Revised Exhibit C-13 14. GHC of Fresno, LLC d.b.a. Horizon Health & Subacute Revised Exhibit C-14 Center 15. GHC of Anberry, LLC d.b.a. Anberry Nursing and Revised Exhibit C-15 Rehabilitation Center 16. RG Legacy 11, LLC d.b.a. Pasadena Nursing Center Revised Exhibit C-16 Revised 7.17.24 EXHIBIT C-1-1 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2024-25) 7tn AVENUE CENTER, LLC 1171 7t" Avenue Santa Cruz, CA 95062 Number of Licensed Beds: 99 Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for persons served who are temporarily [not more than seven (7) days] absent from a facility. An emergency MHRC bed- hold for psychiatric and non-psychiatric reasons beyond seven (7) day must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay up to the first seven (7) bed-hold days and approval must be provided by the County for any additional days after consulting with the Contractor. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond seven (7) days is necessary. The Contractor will notify the County immediately if Contractor has knowledge that the person served will require treatment at a facility or is eloped lasting seven (7) days or more. A bed hold for non-psychiatric include, but are not limited to, medical hospitalization or elopement. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired and without these services would most likely need acute care. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form. EXHIBIT C-1-1 Page 2 of 3 The need for continuing Enhanced Services will be re-assessed on a weekly to monthly basis throughout the individual's stay. III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. IV. RATES* Program Services Rate Basic Daily Rate $ 290.46 per client per day Bed Hold Rate $ 283.61 per bed per day Enhanced Services Rate $ 200-400 per bed per day 1:1 Supervision $ 400 per day Other Services Rate Physician/Psychiatric Services^ $ per visit; $ for intake * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form. ^ Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds) shall be billed through the Contractor via the monthly services invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in the monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but are not limited to, date and location of service, service provided, service duration, name of provider. Should a client require 1:1 Supervision longer than 24 hours while awaiting return to his/her home county, there will be an additional charge of $400.00 per day for a period not to exceed five (5) days. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-1-1 Page 3 of 3 County agrees to provide designated placement when acute hospitalization is deemed necessary. County agrees to reimburse Contractor for all costs related to transportation. Resident Medi-Cal Status during Stay: COUNTY agrees that resident's Medi-Cal status remains within their county of origin throughout their stay at the facility and agrees not to change resident's Medi-Cal county status to Santa Cruz County. EXHIBIT C-5-1 Page 1 of 2 DESCRIPTION OF SERVICES & RATES (FY 2024-25) HELIOS HEALTHCARE, LLC, d.b.a IDYLWOOD CARE CENTER 1002 West Fremont Avenue Sunnyvale, CA 94087 Number of licensed beds: 185 Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adult persons served between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for persons served who are temporarily [not more than seven (7) days] absent from a facility. An emergency bed-hold for psychiatric and non-psychiatric must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay up to the first seven (7) bed-hold days and approval must be provided by the County by using the Special Services Authorization Form. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond seven (7) days is necessary. The Contractor will notify the County immediately if Contractor has knowledge that the person served will require treatment at a facility or is eloped lasting seven (7) days or more. A bed hold for non-psychiatric include, but are not limited to, medical hospitalization or elopement. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. ENHANCED SERVICES: Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve persons who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for a person served on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the person served is provided any services by using the Special Services Authorization Form. II. REQUIREMENTS: Contractor shall provide available beds needed for authorized County persons served during each term of the Agreement. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. III. RATES: The following are the rates per person served per day: Program Services Rate Enhanced Services Rate— Tier 1* $ 137.00 per day Enhanced Services Rate— Tier 2* $ 163.00 per day Enhanced Services Rate— Tier 3* $ 199.00 per day 1:1 Rate $ 31.00 per hour Bed Hold Rate** Reduction of$ 8.93 from Service Rate EXHIBIT C-5-1 Page 2 of 2 *All rates other than the above listed Enhanced Service Rates must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the above listed Enhanced Service Rates, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form. **The rate reduction for bed holds or leave of absence is $8.93 (raw food cost) per diem for dates of service for FY 24-25. The identified rates include room and board, nursing care, special treatment program services, activity program, over-the-counter medications, diet, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22, CCR, section 51511 C. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a person served residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible persons served in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal persons served or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-8-1 Page 1 of 2 DESCRIPTION OF SERVICES & RATES (FY 2024-25) MENTAL HEALTH MANAGEMENT I, INC., d.b.a. CANYON MANOR 655 Canyon Road Novato, CA 94947 Number of Licensed Beds: 89 Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for persons served who are temporarily [not more than seven (7) days] absent from a facility. An emergency MHRC bed- hold for psychiatric and non-psychiatric reasons beyond seven (7) day must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay up to the first seven (7) bed-hold days and approval must be provided by the County for any additional days after consulting with the Contractor. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond seven (7) days is necessary. The Contractor will notify the County immediately if Contractor has knowledge that the person served will require treatment at a facility or is eloped lasting seven (7) days or more. A bed hold for non-psychiatric include, but are not limited to, medical hospitalization or elopement. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. 11. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form. III. REQUIREMENTS EXHIBIT C-8-1 Page 2 of 2 Contractor shall provide available beds needed for authorized County clients during the term of this Agreement. The County does not guarantee any minimum number of beds. IV. RATES Program Services Rate Basic Daily Rate* $ 401.66 Bed Hold Rate** $ 392.73 Other Services Rate One on One Rate per 8 hour Shift^ $ 477.68 * The Basic Daily Rate shall be inclusive of all psychiatric services such as weekly visits, initial psychiatric assessment and two affidavits for LPS conservatorship renewal per year. **The rate reduction for bed holds or leave of absence is $8.93 (raw food cost) per diem for dates of service for FY 24-25. ^ Only applicable for those counties contracted for one on one services. **Any rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County.