COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

September 9, 2004

BOARD MEETING DATE:

September 28, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health Services

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreement with Mt. Diablo Medical Pavilion

Recommendation

Adopt a resolution authorizing the President of the Board to execute an agreement with Mt. Diablo Medical Pavilion.

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). Mt. Diablo Medical Pavilion first contracted with the County to provide these services in March 2001. For FY 2003-04, the Mental Health Services Division contracted with Mills-Peninsula Hospitals, St. Mary’s Hospital and Medical Center, Sequoia Hospital and Medical Center, and Mt. Diablo Medical Pavilion to provide inpatient mental health services.

Discussion

The Mental Health Services Division is renewing agreements with Mills-Peninsula Hospitals, St. Mary’s Hospital and Medical Center and Mt. Diablo Medical Pavilion. The agreement with Mt. Diablo is a two-year agreement for FY 2004-05 and FY 2005-06. The agreements with Mills-Peninsulas Hospitals and St. Mary’s Hospital and Medical Center will be for FY 2004-05 only, and will be presented to your Board once we have received necessary insurance documents.

This agreement contains rates for services to Medi-Cal clients for FY 2004-05, which were negotiated between Mt. Diablo Medical Pavilion and the facility’s host county, Contra Costa County. Rates for FY 2005-06 for this agreement will be established through subsequent negotiations between Contra Costa County and Mt. Diablo Medical Pavilion. Inpatient rates for services to Medi-Cal-covered and uninsured youth are included as are Administrative Day rates, which will be reimbursed based on the rate set by the state. For FY 2004-05 the total maximum amount for the three hospitals agreements, collectively, is $882,411. We anticipate the same umbrella agreement amount for FY 2005-06. The total maximum for the two years, FY 2004-05 and FY 2005-06, for this agreement with Mt. Diablo Medical Pavilion is $1,764,822. There are no separate contract maximums for individual hospitals.

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 negotiated rate schedule is below:

Daily Inpatient Medi-Cal

Rate

FY 2004-05

Daily Inpatient Uninsured Rate

FY 2004-05

Admin Day Rate

FY 2004-05

$680.00

$780.00

$296.03

The objective and actual performance for FY 2003-04 and objectives for FY 2004-05 are:

Performance Measure

2003-04 Objective

2003-04 Actual

2004-06 Objectives

Daily Inpatient Uninsured Rate

Admin Day Rate

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

10% or less

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 agreement is effective July 1, 2004 through June 30, 2006 and carries 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 agreement is structured on the basis of fee-for service 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 $882,411. Of that amount, $630,924 will be funded with state and federal Medi-Cal funds, $188,615 will be funded with realignment funds and the remaining $62,872 is the net County cost. The funding for this agreement has been included in the FY 2004-05 and FY 2005-06 approved Mental Health Services budgets.