Memorandum
Date: May 17th, 2022
To: The Honorable Lake County Board of Supervisors
From: Todd Metcalf, Director Behavioral Health Services
Subject: Discussion of Lake County Behavioral Health Services Request for Proposals Process for FY 2022-23 and Approve Contracting with Facilities/Providers who did not Submit Proposals to Maintain Continuity of Client Care.
Executive Summary:
In conformity with the County of Lake’s competitive bidding and consultant selection policy and ordinance, Lake County Behavioral Health Services has issued a Request for Proposals for a variety of services that have been historically contracted out. Among these, an RFP was initiated for Adult Mental Health Residential Treatment Services on March 3rd 2022 and Acute Psychiatric Hospital Services on March 14th.
Adult Residential Treatment Services are rehabilitative services provided in a non-institutional, residential setting for beneficiaries who would be at risk of hospitalization or other institutional placement if they were not in a residential treatment program. Adult Residential Treatment Services include a range of activities and services that support beneficiaries in their effort to restore, maintain and apply interpersonal and independent living skills and to access community support systems. The service is available 24 hours a day, seven days a week. We also included in this RFP a request for proposals for Board and Care facilities.
LCBHS received one proposal from a contractor with whom we have placed clients for many years. We have received rate sheets from most of our other contracted providers, as they assume we will want to continue to contract with them due to the limited availability of residential beds in the state of California. Largely, these rates are set by the Department of Health Care Services. Contractors have indicated they would not go through the trouble of submitting a proposal, as beds are highly competitive.
Similarly, with Acute Psychiatric Hospital Services, we did not receive any proposals. Despite this, our clients continue to have a need for these services and we have an obligation as the County Mental Health Plan to insure provision of these services.
Additionally, Regulations state: The MHP shall give practitioners or groups of practitioners who apply to be MHP contract providers and with whom the MHP decides not to contract written notice of the reason for a decision not to contract (42 C.F.R. § 438.12(a)(1). It is unclear whether DHCS will find it acceptable to decline to contract with a provider because they did not participate in the RFP process or because their proposal was not selected; counties are still awaiting guidance on this.
We desire to discuss with the Board our intention to continue to contract with facilities with whom we have clients currently placed and in facilities for which we have anticipated/projected utilization in the absence of a formal proposal. In absence of this, we have a grave concern that the welfare and care of our most vulnerable beneficiaries is in jeopardy.
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Recommended Action: Approve LCHBS’ recommendation to contract with Adult Residential Treatment Services and Acute Psychiatric Hospital Services providers in the absence of a successful Request for Proposals Process in Order to Maintain Continuity of Care for Lake County Beneficiaries.