COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

January 8, 2004

BOARD MEETING DATE:

January 27, 2004

TO:

Honorable Board of Supervisors

FROM:

Margaret Taylor, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Amendment to the Agreement with Santa Clara County

Recommendation

Adopt a resolution authorizing the President of the Board to execute an amendment to the Agreement with Santa Clara County for services at Starlight Adolescent Center.

Background

In 1999 Santa Clara County was selected by the State as one of the host counties to develop a regional Community Treatment Facility (CTF), Starlight Adolescent Center. A CTF is a locked facility for seriously emotionally disturbed adolescents, who require the most intensive and secure treatment. Starlight is the only regional locked facility available for San Mateo County youth. The goal of the Starlight Adolescent Center is to treat these adolescents in a community setting and to return them to a less restrictive environment as soon as possible. Mental Health negotiated for two beds at Starlight. On June 25, 2002, your Board approved an agreement with Santa Clara County for these services. That agreement provided interim daily rates but requires that actual costs to be determined by a cost report process after the close of the service year. The use of this locked placement facility decreased with the opening of Canyon Oaks youth facility. Services are provided as needed on a fee-for-service basis.

Discussion

This amendment to the Agreement establishes actual costs for FY 2001-02 and interim rates for FY 2002-03. It also increases the amount to be paid for FY 2001-02 to reflect the final cost report, and establishes the maximum amount to be paid for FY 2002-03. Although the agreement includes both Medi-Cal and non-Medi-Cal rates, Mental Health has placed only Medi-Cal eligible clients at Starlight for both years.

One San Mateo County youth is currently placed at Starlight who otherwise would have required placement in a State Hospital. Due to a high level of emotional disturbance and ongoing severe behavioral issues this youth is not appropriate for unlocked placement at Canyon Oaks. In November 2002, Santa Clara County notified Mental Health Services that the actual rates for FY 2001-02 and FY 2002-03 for Medi-Cal eligible youth would be higher than the interim rates.

Santa Clara County has prepared this amended Agreement. They require that we are the first signer of the Agreement. This amendment is late due to delay in preparation of the amendment by Santa Clara County, and verification by Mental Health of the actual and interim costs.

We will present to your Board an agreement with this provider for FY 2003-04 when it is received from Santa Clara County. We expect limited use of these services due to the opening of Canyon Oaks. Only youth who are inappropriate for placement at Canyon Oaks will be placed at Starlight.

Vision Alignment

This amended Agreement with Santa Clara County 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 amended Agreement contributes to this commitment and goal by providing intensive mental health services at Santa Clara's Community Treatment Facility for seriously emotionally disturbed San Mateo County youth.

Fiscal Impact

The term of this amended agreement continues to be July 1, 2001 through June 30, 2003. The actual cost for FY 2001-02 is $108,043, and the new maximum cost for FY 2002-03 is $120,000. The new maximum for this amended agreement is $228,043. Costs have been calculated in accordance with Short/Doyle regulations, and only actual expenses will be paid. The actual costs for FY 2002-03 are expected to be determined in the spring of this year.

These services will be 100% reimbursable by State and Federal Medi-Cal and SB 90 funds. There is no net county cost.