COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

August 20, 2003

BOARD MEETING DATE:

September 9, 2003

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director of Health Services

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreements with Mills-Peninsula Hospitals and Mt. Diablo Medical Pavilion

Recommendation

Adopt a resolution authorizing:

1. The President of the Board to execute agreements with Mills-Peninsula Hospitals and Mt. Diablo Medical Pavilion; and

2. The Director of Health Services to execute minor amendments and adjustments up to an aggregate of $25,000 for the term of the agreements.

Background

In March 1995, your Board approved the acceptance of state and federal funds to implement the San Mateo County Mental Health Managed Care Plan (MHP). Mills-Peninsula Hospitals has contracted with us since 1995 to provide authorized inpatient mental health services as part of the County Mental Health Plan managed care program. Mt. Diablo Medical Pavilion first contracted with the County to provide these services in March 2001. For FY 2002-03, the Mental Health Services Division contracted with four hospitals to provide inpatient mental health services.
Those facilities are Mills-Peninsula Hospitals, Mt. Diablo Medical Pavilion, Sequoia Hospital, and St. Mary's Hospital and Medical Center.

Discussion

Mental Health is renewing agreements with all four hospitals for FY 2003-04. The agreements with Sequoia Hospital and Medical Center and St. Mary's Hospital and Medical Center will be presented to your Board once we have received necessary insurance documents.

The FY 2003-04 agreements for these hospitals have negotiated rates for services to Medi-Cal clients. Medi-Cal rates are all-inclusive except for professional fees for doctors, which are paid separately. Inpatient daily rates and crisis intervention services are included for Medi-Cal-covered and uninsured adults and youth at Mills-Peninsula Hospitals. Inpatient rates for services to Medi-Cal-covered and uninsured youth are included for Mt. Diablo Medical Pavilion. Administrative day rates will be reimbursed at each of the hospitals based on the rate set by the state. The total maximum agreement amount for all four hospitals, collectively, is $1,292,000, and there are no separate contract maximums for individual hospitals.

We request that the Director of Health Services be given signing authority to execute minor amendments and adjustments up to an aggregate $25,000 for the term of the agreements.

The negotiated rate schedule is below:

Hospital

Daily Inpatient Medi-Cal Rate

Daily Inpatient Uninsured Rate

Crisis Intervention Rate

Admin Day Rate

Adult

Youth

Adult

Youth

Adult

Youth

Mills-Peninsula Hospitals

$563.10

$592.56

$591.43

$620.88

$72/hr. ($563.10 cap)

$72/hr. ($592.56 cap)

$295.48

Mt. Diablo Medical Pavilion

N/A

$650.00

N/A

$750.00

N/A

N/A

$295.48

The objective and actual performance for FY 2002-03 and objectives for FY 2003-04 are:

Performance Measure

Hospital

2002-03 Objective

2003-03 Actual

2003-04 Objective

Percent of clients who needed to be re-admitted within 30 days of a completed episode of care

Mills-Peninsula Hospitals

10%

20%*

10%

Mt. Diablo Medical Pavilion

10%

7%

10%

* The MHP expects the availability of Canyon Oaks to reduce the number of re-admissions to Mills-Peninsula Hospitals and will work with this provider to decrease the frequency of re-admissions.

Vision Alignment

This managed care agreement 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. This agreement contributes to this commitment and goal by providing mental health services for San Mateo County youth and adults.

Fiscal Impact

The agreements are effective July 1, 2003 through June 30, 2004 and carry a 30-day termination clause for both parties. County Counsel has reviewed and approved the agreements and Risk Management has approved the insurance coverage.

This agreements are structured on the basis of fee-for service negotiated rates. Only services authorized by San Mateo County Mental Health Services will be paid. The collective agreement maximum amount for all contracted inpatient psychiatric facilities is $1,292,000. Of that amount, $1,162,800 will be funded with state and federal Medi-Cal funds and the remaining $129,200 is the net County cost. The funding for these agreements has been included in the FY 2003-04 approved Mental Health Services budget.