COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

December 19, 2003

BOARD MEETING DATE:

January 13, 2004

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Third Amendment to the Agreement with Edgewood Center for Children and Families

Recommendation

Adopt a resolution authorizing the President of the Board to execute the Third Amendment to the Agreement with Edgewood Center for Children and Families.

Background

Since 1996 Edgewood Center for Children and Families has been providing Day Treatment Intensive Services to San Mateo County children and youth. In April of 2001 they were the only agency that responded to a pre-proposal survey to provide Day Treatment Intensive Services. On September 25, 2001 your board approved an Agreement with Edgewood to provide the following mental health services for San Mateo County children and youth: Day Treatment Intensive Services, Therapeutic Behavioral Services (TBS), hospital diversion services or Diagnostic Assessment Program, and outpatient mental health services to youth and their families through the Mental Health Plan (MHP). TBS is a State-mandated Medi-Cal service. The term for each of these services, other than the MHP services, was from July 1, 2001 through June 30, 2002. The term for the MHP services was July 1, 2001 through June 30, 2004.

On October 8, 2002 your board approved an Amendment to the Agreement with Edgewood to extend the terms for Day Treatment Intensive Services and TBS through June 30, 2004, and to revise the service requirements for those programs to match current state regulations. The term for services through the MHP remained through June 30, 2004. The term for the Diagnostic Assessment Program expired June 30, 2002, and was not extended as the contractor had discontinued provision of those services.

On July 25, 2003, pursuant to your board's September 25, 2001 resolution, the Director of Health Services approved a second Amendment to the Agreement with Edgewood to reallocate FY 2002-03 funds in the amount of $6,030 to be moved from Day Treatment Intensive Services to mental health services for youth and their families through the Mental Health Plan (MHP). New Health Insurance Portability and Accountability Act of 1996 (HIPAA) provisions were also added to the Agreement at that time.

Discussion

The California State Department of Mental Health has imposed new regulations for Medi-Cal reimbursement of TBS, Day Treatment Intensive Services and Day Treatment Rehabilitative Services effective July 1, 2003. This Agreement is being amended to clarify service and documentation procedures for TBS, and to add Day Treatment Rehabilitative Services and Outpatient Mental Health Services according to these new regulations.

For the period April 1, 2003 through June 30, 2004 the following Outpatient Mental Health Services are being added to the Agreement: Medication Support Services, such as prescribing, administering, dispensing and monitoring of psychiatric mediations necessary to alleviate the symptom of mental illness; Mental Health Services (family therapies); and Crisis Intervention services.

Vision Alignment

This amended Agreement with Edgewood Center for Children and Families 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 amended Agreement contributes to this commitment and goal by providing Day Treatment Intensive Services, TBS, and Outpatient Mental Health Services to seriously emotionally disturbed youth.

Fiscal Impact

The amended Agreement maximum of $523,943 is unchanged for the three-year term of July 1, 2001 through June 30, 2004. The maximum for mental health services through the Mental Health Plan (MHP) is being increased by $5,000 for FY 2003-04 to $30,000. The MHP increase and the addition of Outpatient Mental Health Services is being offset by a reduction in FY 2002-03 and FY 2003-04 Day Treatment costs due to fewer number of clients served than originally anticipated.

The maximum for FY 2003-04 is $137,930. Federal and State Medi-Cal are expected to fund a total of $48,275 or 35%. The balance will be covered under funding for youth services under Title 1, Div. 7, Chapter 26.5 of the Government Code (mental health services to special education certified youth) through an SB90 state mandated claim reimbursement. There is no net county cost.