Inter-Departmental Correspondence

Health Services Agency



December 3, 2003


December 16, 2003



Honorable Board of Supervisors



Margaret Taylor, Director of Health Services


Gale Bataille, Director, Mental Health Services



Agreement with Telecare Corporation



Adopt a resolution authorizing the President of the Board to execute an agreement with Telecare Corporation.



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 Corporation 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.



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, and 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 this agreement clients will receive pharmacy services through the Mental Health Pharmacy Benefits Management (PBM) provider.


Health Services has another agreement with Telecare, which will be brought to your Board separately. That agreement is for the provision of mental health services at Cordilleras Mental Health Center and Gladman Mental Health Rehabilitation Facility, and for Tuberculosis Treatment Services.


Consistent with contract approval level limitations in County Administrative Memorandum B-1, the Director of Health Services will be authorized to execute amendments and modifications to this agreement, not to exceed $25,000 in aggregate.


The objectives and actual performance from FY2002-03 and objectives for FY2003-04 are below.

Performance Measures

2002-03 Objective

2002-03 Actual

2003-04 Objective

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




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




Reduction of total days of psychiatric hospitalization for enrolled program clients in comparison to total days enrolled 12 months prior




Reduction of total days of incarceration will be reduced for enrolled program clients in comparison to total days enrolled 12 months prior





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 and goal by providing supported housing and intensive community treatment for mentally ill persons who are homeless.


Fiscal Impact

The agreement term is from July 1, 2003 through June 30, 2004 and has been reviewed and approved by County Counsel and Risk Management. The total program cost is $1,249,274, with member SSI payments covering $100,000. The Agreement maximum is $1,149,274, which is included in the approved FY 2003-04 budget. The AB 2034 grant funds will reimburse $832,386 and the balance of $316,888 will be funded by state and federal Medi-Cal. There is no net County cost.