COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

 

DATE:

November 25, 2002

BOARD MEETING DATE:

December 17, 2002

 

TO:

Honorable Board of Supervisors

   

FROM:

Margaret Taylor, Director of Health Services

 

Gale Bataille, Director, Mental Health Services

   

SUBJECT:

Agreement with Telecare Corporation

 

Recommendation

Adopt a resolution authorizing the President of the Board:

 

1.

To execute an agreement with Telecare, Inc., and

2.

To authorize the Director of Health Services to execute amendments and minor modifications to the agreement.

 

Background

In December 2000, the State Department of Mental Health awarded $1.5 million in AB 2034 grant funding to San Mateo County to implement a program for homeless mentally ill persons. In February 2001, your Board accepted the AB 2034 grant funding and approved a five-year lease with the Department of Veterans Affairs, Palo Alto Health Care System (VAPAHCS) to provide space for housing for up to 40 homeless individuals. Also in February 2001 Telecare, Inc. was selected through an RFP process to provide the services portion of this program, known as the Transitions Program. This program includes supported housing services at VAPAHCS, and an intensive community treatment team known as the Assertive Community Treatment (ACT) team to serve 75 mentally ill clients who are homeless or at risk of becoming homeless. In addition to the services for clients of the 40-bed residence at VAPAHCS, Telecare Transitions Program purchases interim housing resources for clients who do not reside at the VAPAHCS. The Transitions Program serves 75 homeless mentally ill adults and transition age youth. Your Board approved an agreement with Telecare to provide these services from March 27, 2001 through June 30, 2002.

 

Discussion

Health Services is renewing this agreement with Telecare, Inc. to provide services for 65 adults and 10 transition youth who are seriously and persistently mentally ill, and are homeless or at immediate risk of becoming homeless. Program participants may have co-occurring drug and alcohol problems. The ACT team functions as the point of entry to the program, providing outreach to individuals who are on the streets, arrive at Psychiatric Emergency Services or are in homeless shelters. This outreach is critical to successful enrollment of homeless mentally ill persons, many of who have been unwilling or reluctant to use more traditional mental health services. Juvenile Probation and Human Services may refer transition age youth to the program, including youth emancipating from foster care.

 

Under the prior agreement pharmacy services were provided to clients in this program. Under this agreement clients will receive pharmacy services through the Mental Health Pharmacy Benefits Management (PBM) provider. For these services $107,500 has been shifted from this agreement.

 

The objectives and actual performance from FY2001-02 and objectives for FY2002-03 are below.

Performance Measures

2001-02 Objective

2001-02 Actual

2002-03 Objective

Percent of VAPAHCS residents and intensive treatment program enrollees who will report satisfaction with services and supports

85%

89%

85%

Percent of individuals leaving the VAPAHCS residence who will move to more independent residential settings

75%

64%**

65%

Collective total days of psychiatric hospitalization will be reduced for enrolled program clients in comparison to total days in the 12 months prior to enrollment*

50%

40%**

45%

Collective total days of incarceration will be reduced for enrolled program clients in comparison to total number of days in 12 months prior to enrollment*

50%

28%**

40%

* - Reductions are reported only for clients with 12 months post-enrollment data.

** - Projections for the first year of service were set without baseline data, which is provided here. These data are from the first 8 months of program operation, and reflect significant positive results. Mental Health will continue to work with the Contractor to improve program performance.

 

Vision Alignment

This agreement with Telecare Corporation 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 agreement contributes to this commitment by providing supported housing and intensive community treatment for mentally ill persons who are homeless.

 

Fiscal Impact

The agreement term is from July 1, 2002, through June 30, 2003 and has been reviewed and approved by County Counsel and Risk Management. The total program cost is $1,249,274. Member SSI payments will cover $100,000 so the net cost of this agreement is $1,149,274, which is included in the FY 2002-03 budget. The AB 2034 grant funds will reimburse $949,049 and the balance of $200,225 will be funded by state and federal Medi-Cal. There is no net County cost.

 

This agreement is late because Mental Health delayed processing the agreement until the budget was approved and State funding was confirmed for these services.

 

We request that the Director of Health Services or her designee be given signing authority to execute minor amendments and modifications up to an aggregate of $25,000 for the term of the agreement.