COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

March 10, 2003

BOARD MEETING DATE:

March 25, 2003

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Amendment to the Agreement with YMCA of San Francisco: Peninsula Family Branch, dba North Peninsula Family Alternatives.

Recommendation

Adopt a resolution authorizing the President of the Board to execute an amendment to the agreement with YMCA of San Francisco: Peninsula Family Branch, dba North Peninsula Family Alternatives.

Background

Juvenile sex offenders are a difficult high-risk population to treat due to their need for close monitoring, specialized long-term treatment, and their high recidivism rate. Research studies from the Office of Juvenile Justice report that the successful treatment of this population is dependent on continuity of treatment, specialized mental health treatment, and the development of close collaborative relationships between the agencies treating, supervising and monitoring the offender.

Mental Health Services contracts with North Peninsula Family Alternatives (NPFA) to provide Juvenile Sexual Responsibility (JSR) services to approximately 35 youth because of its expertise, knowledge of the community, and successful outcomes such as low recidivism. NPFA has successfully provided the JSR Program for the past nine years with a recidivism rate of only 2.2% in comparison to the national rate of 8%. JSR services have been provided under a three-agency collaborative funding agreement (Probation, Human Services Agency, and Health Services). A Board Informational Memo (September 2002) summarized the history of County financial support for JSR and the impact of proposed budget reductions.

Discussion

This agreement is being amended due to the funding reductions pursuant to the FY2002-03 adopted budget. The contract payment limit is reduced by a total of $204,475 for the last two years of the agreement. The number of youth served will be reduced, and mobile treatment services and after care services will no longer be provided. These reductions in funding and service level were reviewed and adopted during September 2002 County budget hearings.

Language regarding the Health Insurance Portability and Accountability Act (HIPPA) of 1996 has been included in this amendment to assure that this provider meets required privacy standards.

Outcome Measures

2001-02 Objective

2001-02 Actual

2002-03 Objective

Juvenile Sexual Responsibility Program

Youth served shall not re-offend (sex offense) during time between four months after admission and two years after completing the program

90%

98%

95%

Family Therapy Program

Families offered family therapy who participate as part of youth’s treatment

33%

35%

15%*

*The objective for family therapy is reduced because funding has been significantly reduced for FY 2002-03 and the contractual service minutes have been cut by 50%.

Vision Alignment

This amended agreement with NPFA 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 and goal by providing a juvenile sexual responsibility program and mental health services.

Fiscal Impact

The term of this agreement remains as July 1, 2001 through June 30, 2004. The agreement has been reviewed and approved by both County Counsel and Risk Management.

The original agreement maximum was $760,061. The amended agreement maximum is $555,586, with reductions of $97,782 for this year and $106,693 for FY 2003-04, including elimination of 5% COLAs for the Juvenile Sexual Responsibility program for years two and three of the agreement. $80,430 has been included in the adopted Mental Health Service’s budget for this year. Of that amount the Human Services Agency, Probation Department and Mental Health Division each provide $21,810, totaling $65,430. Federal and state Medi-Cal will fund the remaining $15,000. In addition to the agreement funding, client fees will generate an additional $27,244 to offset the budget reductions. Total estimated Juvenile Sexual Responsibility program costs are $107,674 for FY 2002-03.

Federal and state Medi-Cal will fund $75,000 for outpatient mental health services through the MHP for each year of the contract. The Mental Health Division net County cost for this year is $21,800. A similar arrangement will be in place for fiscal year 2003-04.