COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

April 2, 2004

BOARD MEETING DATE:

April 20, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene Silva, Director of Health Services

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreement with St. Mary's Hospital and Medical Center

Recommendation

Adopt a resolution authorizing the President of the Board to execute an Agreement with St. Mary's Hospital and Medical Center.

Background

In March 1995, your Board approved the acceptance of state and federal funds to implement the San Mateo County managed care Mental Health Plan (MHP). St. Mary's Hospital and Medical Center has contracted with us since 1995 to provide authorized inpatient mental health services as part of the County MHP managed care program. 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 Medical Center, and St. Mary's Hospital and Medical Center.

Discussion

Mental Health is renewing agreements with all four hospitals for FY 2003-04. Your Board approved the agreements with Mills-Peninsula Hospitals and Mt. Diablo Medical Pavilion on September 9, 2003. This Agreement is delayed due to late return of the Agreement and accompanying requested documents by Contractor. The agreement with Sequoia Hospital and Medical Center will be presented to your Board once it is returned by the Contractor.

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 are included for Medi-Cal-covered and uninsured youth at St. Mary's Hospital and Medical Center. Administrative day rates will be reimbursed at each of the four hospitals based on the rate set by the state. The total maximum agreement amount for all the hospitals, collectively, is $1,292,000, and there are no separate contract maximums for individual hospitals.

The negotiated daily rate schedule is below:

Hospital

Daily IP

Medi-Cal

Rate

Daily IP

Uninsured

Rate

One-to-One Supervision

Admin. Day Rate

Adult

Youth

Adult

Youth

Youth

St. Mary's

n/a

$702.00

n/a

$862.00

$472.00

$296.03

Performance

Measure

2002-03 Objective

2002-03 Actual

2003-04 Objective

Percent of clients needing re-admission within 30 days of a completed episode of care

10%

10%

10%

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.

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 managed care hospital agreements are for the term 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.

These 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 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 approved FY 2003-04 Mental Health Services budget.