COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

June 5, 2002

BOARD MEETING DATE:

June 25, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Agreement with Santa Clara County for services at Starlight Adolescent Center

Recommendation

Adopt a resolution authorizing the President of the Board to execute an agreement with Santa Clara County for the provision of intensive mental health services for seriously emotionally disturbed San Mateo County youth.

Background

In 1999 Santa Clara County was selected by the State as one of the host counties to develop a regional Community Treatment Facility (CTF). A CTF is a secure (locked) facility for seriously emotionally disturbed adolescents who have been unsuccessful in less restrictive programs, and who require the most intensive and secure treatment. The goal of the Santa Clara program, Starlight Adolescent Center, is to treat these adolescents in a community setting and to return them to a less restrictive environment as soon as possible.

Discussion

Mental Health Services negotiated with Santa Clara for the use of two beds at Starlight during FY 2001-02 and FY 2002-03 for Medi-Cal eligible youth. These beds will be used on a fee for service basis. Two youth have been placed at Starlight who otherwise would have required placement in a State Hospital. Mental Health has planned to transfer these youth to the new Canyon Oaks youth facility when it opens. That opening is now projected for the end of this calendar year. At that time this agreement for the use of these two beds at Starlight will be terminated.

This agreement with Santa Clara County allows placement of San Mateo clients in Starlight Adolescent Center. Rather than requiring liability insurance from Santa Clara County, it includes a separate indemnification and insurance agreement directly between the County and Starlight. The agreement has been delayed due to changes in the rate negotiations between Santa Clara County and the State of California. That delay in rate development resulted in a delay in Santa Clara County's preparation and submission of a service contract to San Mateo County Mental Health. The contract was received on June 3, 2002. Clients were placed without a contract because the only alternative was more expensive placement in a State hospital.

Vision Alignment

This agreement with Santa Clara County keeps the commitment to Ensure Basic Health and Safety for All and goal number 8: Help vulnerable people-the aged, disabled, mentally ill, at risk youth, and others- achieve a better quality of life. The contract contributes to this commitment by providing intensive mental health care at Santa Clara's Community Treatment Facility for seriously emotionally disturbed children.

Fiscal Impact

The term of this agreement is July 1, 2001 through December 31, 2002. It will automatically extend through June 30, 2003, unless terminated by either party. Medi-Cal bed rates have been set by Santa Clara County for FY 2001-02 at $169.12 per day. These rates pay for mental health day treatment services. Funding from the Human Services Agency pays room and board costs. Total Mental Health costs for FY 2001-02 will be $71,876. The cost for FY 2002-03 will be based upon the Medi-Cal bed rates, which have not yet been set by Santa Clara County. The total amount of payments for FY 2002-03 is not known but the contract provides for that costs will be calculated in accordance with state Short/Doyle regulations, and only actual expenses will be paid. An estimate of $45,000 has been included in the proposed FY 2002-03 Mental Health budget for these services. Funding will be provided 49% from realignment funds and 51% from federal financial participation. There is no net county cost.