LA County Board

13. Ensuring the Safe Opening of Mental Health Rehabilitation Center Beds at\nMartin Luther King, Jr. Medical Campus’ Behavioral Health Center\nRecommendation as submitted by Supervisor Mitchell: Authorize the Director of\nMental Health to negotiate, and execute Legal Entity (LE) contracts for the\nprovision of Mental Health Rehabilitation Center (MHRC) services at the\nBehavioral Health Center (BHC) at the Martin Luther King, Jr. (MLK) Medical\nCampus with Life Generations Healthcare, LLC, NewGen Health, and Behavioral\nHealth Management Systems, for a term of three fiscal years with two one-year\nextension options, at an estimated total annual amount not to exceed $6,500,000\nper contract, to be fully funded by Medi-Cal and State Realignment revenues;\nand take the following actions:\nAuthorize the Director of Mental Health to prepare, and execute future\namendments to the contracts to add, delete, modify or replace the\nservice exhibits and/or statements of work, reflect Federal, State, and\nCounty regulatory and/or policy changes, revise the annual Maximum\nContract Allowances (MCAs), provided that the increase will not exceed\n25% of the applicable MCA and sufficient funds are available, terminate\nthe contract in accordance with the contract termination provisions,\nincluding termination for convenience or termination for any repeated\nperformance or quality of care issues, and increase monitoring or\nrequire corrective action plans as appropriate;\nAuthorize the Director of Mental Health to make non-material\nmodifications to the LE contract through administrative amendments or\nchange notices for the following and other similar reasons, as\nappropriate: change the LE contractor’s business name and/or\nheadquarters address; change, revise, add, or delete the LE contractor’s\nprovider site address(es), site number(s), and/or site name(s); make\ntechnical corrections; revise County and contractor administration\nexhibits; and/or shift funds between currently contracted funded\nprograms, so long as such shift(s) will not cause an increase in the MCA;\nExempt the Department of Mental Health’s (DMH) LE contract from the\nsix-month advance notification requirement under Board Policy No.\n5.100, when DMH does not have delegated authority to extend the term of\nthe contract;\nInstruct the Director of Mental Health to take the following steps to ensure\nquality of care:\nFor all admitted clients, track and issue quarterly aggregate\nreports, by contractor, on contractor performance metrics\nincluding, but not limited to, client diagnosis, including any special\nbehavior issues affecting the client’s placement, client\ndemographics, including race, ethnicity, age and language\npreference, if known, whether the client has a co-occurring\nsubstance use disorder, where the client was admitted from, the\ncontractors’ usage of seclusion or chemical/physical restraints\nincluding, for each contractor, the specific data that is required by\nCalifornia Health & Safety Code Section 1180; length of stay\n(average, short and longest stays); number (or percentage) of\nclients who were ready for discharge but remained, including a\nnotation of discharge barriers and the number (or percentage) of\nclients who were successfully stepped down to lower levels of\ncare; the number of clients on conservatorship status; the number\nof adverse client incidents, and corrective action taken; the\nnumber of client grievances and subject matter; the instances\nwhere clients require non-routine medical care, including\ntreatment for pressure ulcers or medication errors, urgent care or\nemergency care; in preparation for clients needing emergency\ncare, how contractors and DMH are coordinating with expected\nreceiving hospitals for both psychiatric and non-psychiatric\nemergencies both before and after opening of the beds; and\ncompliance with staff to patient staffing levels, including staff\nturnover rates;\nEnsure the minimal use of seclusion and physical/chemical\nrestraints by requiring contractors to comply with applicable\nFederal, State and local laws, rules and regulations and monitoring\ncontractors’ compliance with those practices, with DMH to\nencourage contractors to meet best community standards;\nTo the maximum extent possible, ensure the contractors’\nemergency and disaster plans align and are coordinated with\nthose of other MLK Medical Campus providers, especially other\nproviders inside the BHC;\nRandomly, but no less than once a month, conduct unannounced\nsite visits, as well as the weekly Health Access and Integration field\nliaison site visits, to ensure the services are meeting the standards\nof the Board’s Care First/Jails Last restorative justice goals and\ndirectives of this motion;\nEvery six months, perform an audit by an appropriately licensed\nclinician on each contractor to ensure adherence to the contract\ncomponents and include findings in the quarterly report, also,\nconduct written audits and utilization reviews by an independent\ncontractor or appropriately licensed clinical Department staff of\ncase files to ensure accuracy of data reports, appropriate staffing\nlevels and training completion requirements are being met, and to\nunderstand reasons for delays in transfers to lower levels of care,\nespecially for clients who have been placed in these beds for more\nthan six months;\nPrior to contract commencement, require contractors to submit\ndetailed staff to patient/client ratios, specific protocols for\npreventing/addressing common adverse patient/client incidents, a\nplan for rapid response to deteriorating client conditions; and staff\ntraining requirements and training schedule; and\nImmediately report back to the Board in writing, any significant\nadverse patient/client incidents including, but not limited to, suicide\nor suicide attempts, absence without leave, death or serious injury\nof clients, significant criminal behavior, significant medication\nerrors, discovery of untreated but preventable serious medical\nconditions, such as pressure ulcers, and/or any other incident\nwhich may result in significant harm to the clients or staff, with\nboth DMH and contractors to report these incidents immediately as\nrequired by contract, with all efforts made to ensure reporting\nwithin 72 hours of occurrence. (24-5084)