Special Notice / Hearing: None
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with A&A Health Services, LLC for Residential and Transitional Care Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with A&A Health Services, LLC for residential and transitional care services, for the term of January 1, 2025 through December 31, 2025, in an amount not to exceed $328,500.
bodyy
BACKGROUND:
Behavioral Health and Recovery Services (BHRS) has contracted with A&A Health Services, LLC since January 1, 2024, for residential care facilities in Contra Costa County to provide residential care services for adults living with a mental illness, and who may have histories of homelessness, substance abuse, or forensic histories. These services enhance successful community living and avoid a more costly, higher level of care.
Out-of-county Board and Care (B&C) facilities serve a critical role in the care of BHRS clients. These facilities provide long-term placements and care for a population of clients that are often stigmatized and perceived as having too many complex issues. The facilities provide clients with meals, assistance attending to activities of daily living, medication support, and social skills development. These facilities are needed due to the limited number of beds available at in-county B&C facilities.
In recent years, the San Mateo County B&C market has been struggling. Established B&C contractors have been retiring and closing their operations, and new facilities are not being opened to succeed them. BHRS attempted to engage with B&C operators who are not contracted with San Mateo County, but these operators are not interested in serving clients with severe mental illness or contracting for relatively low expected revenue.
As a result, over the past few years, BHRS lost six in-county contracted B&C facilities, resulting in a total loss of 41 B&C beds. In response, BHRS has had to contract with out-of-county providers to address the loss of in-county B&C beds.
This agreement is exempt from the competitive procurement process due to the particular needs of the clients served by B&C facilities, the uniqueness of the local B&C market, and the B-1 Administrative Memo exception for Housing Services and Related Supports.
DISCUSSION:
Under this agreement, A&A Health Services, LLC shall continue to provide beds for difficult-to-place clients and augmented services for adults with a severe mental illness who require a higher level of care and supervision. These services include supplemental intensive mental health services, social skills training, and assistance with daily living activities. This agreement will provide up to a maximum of four beds per month.
The resolution contains the County’s standard provisions allowing amendments of the County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that 75% of clients will be discharged to an acute (i.e. lower) psychiatric level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of clients that will be discharged to an acute (i.e. lower) psychiatric level of care |
75% 3 clients |
75% 3 clients |
EQUITY IMPACT:
This agreement will positively impact a critically undeserved community of BHRS clients who have severe mental illness and need a residential placement. Residential providers such as A&A Health Services, LLC is a vital resource for housing such individuals. This agreement with A&A Health Services, LLC affords these individuals an ability to step down from higher acute, more costly levels of care to a community placement. This provider is committed to serving this population and supporting them with being successful while living in a community setting.
FISCAL IMPACT:
The term of the agreement is January 1, 2025 through December 31, 2025.The amount of the agreement is not to exceed $328,500 for the one-year term. For FY 2024-25 the maximum amount is $328,500 and will be included in the BHRS FY 2024-2025 Adopted Budget. Of that amount, it is anticipated that $328,500 will be funded by 1991 Realignment. There is no Net County Cost associate with this agreement.