COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

September 19, 2002

BOARD MEETING DATE:

October 8, 2002

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Amendment to the Agreement with Edgewood Center for Children and Families

Recommendation

Adopt a resolution authorizing the President of the Board to execute an amendment to the agreement with Edgewood Center for Children and Families.

Background

Since 1996 Edgewood Center for Children and Families has been providing intensive day treatment services to San Mateo County children and youth. In April of 2001 they were the only agency that responded to a pre-proposal survey to provide intensive day treatment services. On September 25, 2001 your board approved an agreement with Edgewood to provide the following mental health services for San Mateo County children and youth: intensive day treatment services, Therapeutic Behavioral Services (TBS), hospital diversion services, or Diagnostic Assessment Program, and outpatient mental health services to youth and their families through the Mental Health Plan (MHP). TBS is a State-mandated Medi-Cal service. The term for each of these services, other than the MHP services, was from July 1, 2001 through June 30, 2002. The term for the MHP services is July 1, 2001 through June 30, 2004.

Discussion

This agreement is being amended to extend the terms for intensive day treatment and TBS through June 30, 2004, and to revise the service requirements for those programs to match current state regulations. The term for services through the MHP remains through June 30, 2004. The term for the Diagnostic Assessment Program has not been extended, as the contractor has discontinued provision of those services.

Intensive day treatment services are provided for youth who are placed in this residential facility and to youth who live in their own homes and attend the non-residential program. The new consolidated rate for these residential and non-residential services will be $134.00 per day, up to 561 days per fiscal year, for a yearly maximum of $75,174. TBS is intensive one-to-one behavioral management services to youth at risk. The new rate for this service is $69.60 per hour up to a yearly maximum of $15,000. The State is expected to reduce the rates for TBS in the fall of 2002. If this contractor does not agree to the new rates, the TBS portion of this contract will be discontinued.

Performance Measures

2001 - 02 Objectives

2001 - 02 Actual

2002 - 03 Objective

Intensive day treatment services: Minimum percent of youth who will be placed in less restrictive residential placements upon discharge

90%

100%

90%

Maximum percent of MHP cases treated by contractor that shall be admitted to a psychiatric emergency service unit between the time of intake and a year after intake

5%

0%

5%

Vision Alignment

This amended agreement with Edgewood Center for Children and Families 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 amended agreement contributes to this commitment by providing intensive day treatment services and TBS for seriously emotionally disturbed youth, and outpatient mental health services.

Fiscal Impact

The amended contract maximum is being increased by $180,348, to $523,943 for the three-year term of July 1, 2001 through June 30, 2004. This increase will fund intensive day treatment services and TBS for FY 2002-03 and FY 2003-04. The cost for outpatient services through the MHP remains $75,000.

The amount of the agreement for FY 2002-03 is $115,174, and has been included in the Mental Health Services Division budget. The agreement amount for FY 2001-02 was $293,595, which included $136,875 for the Diagnostic Assessment Program. Federal and State Medi-Cal are expected to fund a total of $35,588 (30.9%). Funding for youth services under Title 1, Div. 7, Chapter 26.5 of the Government Code (mental health services to special education certified youth) through an SB90 state mandated claim reimbursement will cover the balance. There is no net county cost. Similar arrangements will be made for FY 2003-04.