To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-7901; Jan Cobaleda-Kegler, 707-565-5157
Vote Requirement: Majority
Supervisorial District(s): Countywide
Title:
Title
Behavioral Health Services Agreements
End
Recommended Action:
Recommended action
Authorize the Director of Health Services, or designee, delegated authority to execute agreements and/or amendments, subject to review and approval as to form by counsel, as follows:
1) From $586,447 to $786,447, for a retroactive $200,000 increase to address service utilization levels of the Community Support Network Specialty Mental Health outpatient treatment services contract, with a contract term ending on 6/30/25.
2) From $439,000 to $659,000, for a retroactive $220,000 increase to address increased service utilization in the Psynergy Programs Specialty Mental Health outpatient treatment services contract, with a contract term ending on 6/30/25.
3) From $2,782,000 to $3,017,000, for a retroactive $235,000 increase to address increased service utilization in the Drug Abuse Alternatives Center Drug Medi-Cal outpatient treatment services contract, with a contract term ending on 6/30/25.
4) From $1,410,132 to $1,810,132, for a retroactive $400,000 increase to address increased service utilization in the Drug Abuse Alternatives Center Drug Medi-Cal residential treatment services contract, with a contract term ending on 6/30/25.
5) From $385,152 to $400,152, for a retroactive $15,000 increase to address increased utilization in the Siyan Clinical Corporation temporary clinical staffing contract, with a contract term ending on 6/30/25.
6) From $3,800,000 to $5,100,000, for a retroactive $1,300,000 increase to address increased service utilization in the Aurora Behavioral Healthcare - Santa Rosa, LLC dba Santa Rosa Behavioral Healthcare Hospital psychiatric inpatient hospitalization contract, with a contract term ending on 6/30/25.
7) From $616,000 to $651,000, for a retroactive $35,000 increase to address increased utilization in the California Hearing Officers contract, with a term ending 6/30/25.
8) From $1,999,589 to $2,019,589, for a $20,000 increase to address increased service utilization in the Canyon Manor long term care contract, with a contract term ending on 6/30/27.
9) From $1,029,840 to $1,133,840, for a $104,000 increase to address increased utilization in the Mental Health Association of Alameda County patient rights advocate contract, with a term ending 6/30/27.
10) From $156,800 to $325,920, for a $169,120 increase to address increased costs in the California Mental Health Services Authority psychiatric inpatient concurrent review contract, with a contract term ending on 6/30/26.
11) From $1,208,032 to $1,263, 017, for a $54,985 increase to address increased costs in the Progress Foundation adult mental health residential treatment contract, with a term ending 6/30/26.
12) From $742,401 to $777,551, for a $35,150 increase to address increased costs in the Progress Foundation Progress Sonoma crisis residential treatment contract, with a term ending 12/31/25.
13) From $ 4,231,089 to $4,428,372, for a $197,283 increase to address increased costs in the Progress Foundation Harstad House crisis residential treatment contract, with a term ending 6/30/28.
end
Executive Summary:
The Department of Health Services (hereinafter “DHS” or “the Department”) is requesting an additional $2,425,000 in delegated authority is requested for FY 2024-2025 and $560,538 for FY 2025-2026 and future fiscal years for various mental health and substance use disorder services. These increases are necessary to ensure uninterrupted care and meet the evolving needs of the community. No new appropriations are required as the necessary appropriations for these increases are included in the DHS FY 2024-2025 and FY 2025-2026 Adopted Budgets.
Discussion:
DHS contracts with a broad range of licensed providers to provide timely access to high-quality mental health and substance use disorder (SUD) services, as well as providers of administrative and support services. Many of the Department’s behavioral health service contracts are managed within a medical network of care as mandated by Federal and State regulations. Consistent with State requirements for Mental Health Plans (MHPs), the County is expected to maintain an adequate network of service providers based on client need, geographic coverage, culturally appropriate needs, and language capabilities. The Department estimates and works to identify anticipated resource needs and client demand for services throughout the County prior to the fiscal year; however, the volume of services in particular areas or with some service provider types fluctuates and contract adjustments are often needed to meet higher or lower than forecasted levels of service utilization. This item is designed to retroactively update the contract amounts to reflect the actual services rendered for FY 2024-2025.
Key contract and payment areas requiring additional delegated authority for FY 2024-2025 are listed below and additional details of can be found in Attachment 2:
1. Increased Service Utilization from Specialty Mental Health and Drug Medi-Cal Outpatient Treatment Service Providers: DHS requests $655,000 more in delegated authority to address increased service demand for clients receiving outpatient services from specific Specialty Mental Health and Drug Medi-Cal treatment service providers, as follows: $200,000 for Community Support Network, $220,000 for Psynergy Programs, and $235,000 for Drug Abuse Alternatives Center.
2. Increased Service Utilization from Drug Medi-Cal Residential Treatment Service Provider: DHS requests $400,000 more in delegated authority to address increased service demand for clients receiving Drug Medi-Cal residential treatment services from Drug Abuse Alternatives Center.
3. Increased Utilization of Medical Staffing Agency: DHS requests $15,000 more in delegated authority to address increased hours of Siyan Clinical Corporation temporary medical staffing to cover essential services while recruiting for vacant allocations.
4. Increased Service Utilization at Acute Psychiatric Hospital: DHS requests $1,300,000 more in delegated authority to address increased service demand for clients receiving inpatient hospitalization for acute psychiatric care at Aurora Behavioral Healthcare - Santa Rosa, LLC dba Santa Rosa Behavioral Healthcare Hospital.
5. Increased Utilization of Hearing Officer Services: DHS requests $35,000 more in delegated authority to address the increased volume of administrative hearings provided by California Hearing Officers.
6. Increased Service Utilization from Long Term Care Provider: DHS requests $20,000 more in delegated authority to address increased service demand for clients receiving long term care services from Canyon Manor,.
Key contract and payment areas requiring additional delegated authority for FY 2025-2026 are listed below and additional details of can be found in Attachment 2:
1. Increased Utilization of Patient Rights Advocate Services: DHS requests $104,000 more in delegated authority to address the increased need for patient rights advocate services provided by Mental Health Association of Alameda County.
2. Increased Costs of Psychiatric Inpatient Concurrent Review Services: DHS requests $169,120 more in delegated authority to address the increased costs of psychiatric inpatient concurrent review services provided by the California Mental Health Services Authority.
3. Increased Costs of Adult Mental Health Residential Treatment Services: DHS requests $54,985 more in delegated authority to address the increased costs of adult mental health residential treatment services provided by Progress Foundation.
4. Increased Costs of Crisis Residential Treatment Services: DHS requests $232,433 more in delegated authority to address the increased costs of crisis residential treatment services provided by Progress Foundation.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
On 5/6/25, the Board authorized delegated authority to execute agreements and/or amendments to the California Mental Health Services Authority Interoperability Agreement; to address increased service utilization at Long Term Care Facilities; and to address increased service utilization at Residential Care Facilities.
On 11/12/24, the Board authorized to execute four Drug Medi-Cal Organized Delivery System Substance Use Disorder Residential Treatment services agreements and to execute an agreement with Drug Abuse Alternatives Center for Non-Drug Medi-Cal Organized Delivery System Substance Use Disorder Residential Treatment services.
On 10/22/24, the Board authorized delegated authority to execute agreements and amendments with providers of Behavioral Health services.
On 7/16/24, the Board authorized delegated authority to execute Behavioral Health placement and service agreements and/or amendments and to execute an agreement with Santa Rosa Behavioral Healthcare Hospital.
On 6/12/23, the Board authorized delegated authority to execute agreements and amendments to Mental Health, Substance Use Disorder, and Behavioral Health Support Services.
On 1/13/22, the Board authorized delegated authority to execute agreements and amendments for Administrative Hearing Officer services with California Hearing Officers.
On 6/8/21, the Board authorized delegated authority to execute agreements and amendments for Administrative Hearing Officers.
Fiscal Summary
|
Expenditures |
FY 24-25 Adopted |
FY25-26 Adopted |
FY 26-27 Projected |
|
Budgeted Expenses |
$2,425,000 |
$429,016 |
$131,522 |
|
Additional Appropriation Requested |
|
|
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|
Total Expenditures |
$2,425,000 |
$429,016 |
$131,522 |
|
Funding Sources |
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|
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General Fund/WA GF |
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State/Federal |
$2,425,000 |
$429,016 |
$131,522 |
|
Fees/Other |
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Use of Fund Balance |
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General Fund Contingencies |
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Total Sources |
$2,425,000 |
$429,016 |
$131,522 |
Narrative Explanation of Fiscal Impacts:
The adopted budget for Fiscal Year 2024-2025 included available allocations to cover the additional $2,425,000 needed to fully fund actual services provided in various service provider contracts and support services contracts. Funding sources consist of Federal Funding Participation (FFP), 1991 realignment, 2011 Realignment, Measure O funding, Santa Rosa Behavioral Healthcare Hospital Revenue MOU, and California Proposition 30. The projected expenses for Fiscal Year 2025-2026 are included in the approved budget and are funded with 1991 Realignment, Santa Rosa Behavioral Healthcare Hospital Revenue MOU, and California Proposition 30 revenue. For Fiscal Year 2026-2027 the projected expenses will be included in the proposed budget and will be funded with FFP and Measure O tax funding.
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Staffing Impacts: |
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Position Title (Payroll Classification) |
Monthly Salary Range (A-I Step) |
Additions (Number) |
Deletions (Number) |
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Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Additional Delegated Authority by Provider
Attachment 2 - Key Contracts and Payment Areas Requiring Additional Delegated Authority
Related Items “On File” with the Clerk of the Board:
None