REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  February  28, 2023
CATEGORY:  Consent - Health and Human Services-13.

SUBJECT:

Approve a retroactive amendment with GHC of Auburn, LLC., dba Siena Skilled Nursing Rehabilitation Center for skilled nursing and rehabilitation services, which increases the rates and increases maximum compensation by $1,925,000.

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Miguel Rodriguez, Director of Mental Health, (530) 225-5900

STAFF REPORT APPROVED BY:  Laura Burch, Director, Health and Human Services Agency

RECOMMENDATION

Approve a retroactive amendment, effective June 21, 2022, to the agreement with GHC of Auburn, LLC, dba Siena Skilled Nursing Rehabilitation Center to provide skilled nursing and rehabilitation services which increases the rates effective July 1, 2023 and the maximum compensation by $1,925,000 for a new maximum compensation of $2,250,000, retaining the term June 21, 2022 through June 30, 2025.

DISCUSSION

This agreement is retroactive due to an increase in rates and client services from what was initially projected, necessitating the increase to maximum compensation included with this First Amendment. 

This amendment will allow placement and ongoing long-term residential treatment for adults with a severe and persistent mental illness as an alternative to treatment in an acute inpatient care setting or state hospital; GHC of Auburn, LLC (Siena Skilled Nursing Rehabilitation Center).

Since June 21, 2022, the effective date of the agreement, Shasta County has had a consistent count of five clients placed at the facility each month.  The new maximum compensation accounts for the increased rates and these clients through the end of the contract term, should they remain in the facility.

Residential placement options for severely mentally ill individuals, especially those who need ongoing medical care, are extremely limited.  State psychiatric hospitals and Skilled Nursing Facilities (SNF), such as Siena Skilled Nursing Rehabilitation Center, are among the few options. SNF’s offer advantages to both the individual and to the County over placement in a State psychiatric hospital, including placement to an appropriate lower level of care. SNF’s are less restrictive environments for residential placement and allow County staff to work collaboratively on individualized treatment planning designed to reintegrate the individual into the community when possible.  In addition to collaborative client care, the cost to the County is considerably less than placement in state hospitals. Every attempt is made to keep clients in Shasta County, but occasionally it is necessary to place individuals in an out-of-county treatment facility that can best meet their needs.

Siena Skilled Nursing Rehabilitation Center was chosen due to a limited quantity of qualified SNF care facilities throughout California, and for its relative proximity to Shasta County. When clients are placed within reasonable travel distance to family, friends, and known social supports, better quality of life and mental health outcomes can be achieved.

ALTERNATIVES

The Board could choose not to approve the recommendation, defer consideration to a future date, or provide alternate direction to staff.

OTHER AGENCY INVOLVEMENT

County Counsel has approved the amendment as to form. Risk Management has approved the amendment. This recommendation has been reviewed by the County Administrative Office.

FISCAL IMPACT

The total cost of this amendment for Fiscal Years (FY) 2022-23 through 2024-25 is $2,250,000, if all clients remain in placement at this facility. Costs incurred through this contract are funded through Mental Health Realignment Funding and invoiced to the County on a per client per day basis. Adult Services FY 2022-23 Adopted Budget includes sufficient appropriation authority for the activities described in this agreement and will be included in future year budget submittals.