COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

July 30, 2003

BOARD MEETING DATE:

August 12, 2003

TO:

Honorable Board of Supervisors

FROM:

Gale Bataille, Director, Mental Health Services

Brian Zamora, Director, Public Health

Margaret Taylor, Director, Health Services Agency

SUBJECT:

Agreement with Youth and Family Enrichment Services

Recommendation

Adopt a resolution:

1.

Authorizing the President of the Board to execute a second amendment to the agreement with Youth and Family Assistance (YFA) for 2002-03;

2.

Authorizing the President of the Board to execute a first amendment to the agreement with Family and Community Enrichment Services (FACES) for 2002-03;

3.

Authorizing the President of the Board to execute a superceding agreement with Youth and Family Enrichment Services (YFES) for 2003-04; and

4.

Authorizing the Director of Health Services to execute amendments and minor modifications to this agreement not to exceed the aggregate of $25,000.

Background

For the past several years, the County has contracted with Youth and Family Assistance (YFA) and Family and Community Enrichment Services (FACES) to provide Mental Health and other services. As of July 1, 2003, these organizations merged to form a new entity, Youth and Family Enrichment Services (YFES). In response to this merger, Health Services is recommending a new contract with YFES that will consolidate and supersede the two existing agreements with YFA and FACES. However, before these contracts can be replaced with the new consolidated YFES agreement, it is necessary to amend each of them to reflect changes in their scopes of work. Due to the timing of the amendments and the merging of these two agencies, the amendments and the new superseding agreement with YFES are being brought to your board together.

Discussion

YFA Amendment: The amendment to the existing YFA agreement will add Medi-Cal funded mental health services in the Girls’ Juvenile Drug Court Expansion program. This program is funded by Alcohol and Drug Services of the Human Services Agency through a grant from the U.S. Department of Health and Human Services. These services are Medi-Cal services for Medi-Cal beneficiaries only, which are provided through the Mental Health Plan. YFA was designated as a provider in the grant application submitted by HSA. On October 28, 2002, your Board accepted the funding for this program and waived the Request for Proposal requirement, allowing HSA to contract with these providers.

FACES Amendment: The amendment to the existing FACES agreement will decrease Public Health funding for Prenatal-to-Three Community Worker Services, eliminate Mental Health funding for Pre-to-Three services, and add Medi-Cal funded mental health services for Medi-Cal beneficiaries in the Girls’ Juvenile Drug Court program. The reductions in Pre-to-Three are planned budget reductions. The services for the Girls’ Juvenile Drug Court program are identical to those provided by YFA.

YFES Agreement: The agreement with YFES will supersede the existing agreements with YFA and FACES. The new agreement is for: mental health services in the County Receiving Home; mental health services as authorized by Mental Health Managed Care for Medi-Cal clients; mental health services for the Girl’s Juvenile Drug Court expansion, community worker services for the Pre-to-Three program, and for support of the Youth Development Initiative (YDI).

We are also requesting that the Director of Health Services be given signing authority to execute amendments and minor modifications to this agreement not to exceed a total of $25,000 for the term of the agreement.

The objectives for the services that will be provided in the consolidated agreement and actual performance outcomes for the existing contracts are below.

Performance Measure

2002-03 Objectives

2002-03 Actuals

2003-04 Objectives

Insights Receiving Home Program will increase youth served in 2003-04.

30 youth

8*

30

Percentage of youth receiving Mental Health Services (authorized by MHP) not requiring psychiatry emergency service during one year following initiation of treatment.

95%

99%

95%

Girls’ Juvenile Drug Court Program participants will reduce utilization of Psychiatric Emergency Services and psychiatric hospitalization by.

10%

n/a

Establish baseline service level

Prenatal-to-Three Community Worker Services: Number and percent of babies in Pre-to-Three who are breastfed.

2,280/ 76%

2,280/ 76%

2,280/ 76%

YDI: Percent of participants who report being more aware of youth issues and principles of youth development will increase.

90%

83%

90%

* The contractor had a staff turnover in the last year. They will be fully staffed in FY 03-04.

Vision Alignment

This agreement will keep 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 substance abuse services, outpatient dual diagnosis services for adolescents as authorized by the Mental Health Plan, homeless teen health care services and youth asset development services.

Fiscal Impact

YFA Amendment: The term of the YFA amended agreement is July 1, 2001 to June 30, 2004. The original contract is for $609,842. This amendment adds $40,000 for Mental Health Juvenile Drug Court Expansion Program services, increasing the maximum to $649,842. The increase is $8,333 for FY 2002-03 and $31,677 for FY 2003-04. These costs are 100% reimbursable by Medi-Cal.

FACES Amendment: The term of the FACES amended agreement is July 1, 2001 through June 30, 2004. The original contract is $2,300,083. This amendment adds $8,333 for Mental Health Juvenile Drug Court Expansion Program services for FY 2002-03 and $31,667 for FY 2003-04. For FY 2003-04 there are also reductions in Pre-to-Three services for Mental Health of $255,571 and Pre-to-Three services for Public Health of $225,840. The net reduction for FY 2003-04 is $449,744. The new maximum is $1,858,672. These costs are 100% reimbursable by Medi-Cal.

YFES Agreement: The new YFES contract term is July 1, 2003 through June 30, 2004. The agreement maximum is $482,146. The Mental Health Services maximum is $99,834, which is fully reimbursable through Medi-Cal. $282,312 is for Pre-to-Three Community worker services, which is paid for by grants and Medi-Cal reimbursements; and $100,000 is for the Youth Development Initiative. All of these are included in the 2003-04 budget for Health Services. The net county cost is $100,000 for the Youth Development Initiative.