COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

April 26, 2004

BOARD MEETING DATE:

May 11, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Performance Agreement with the State Department of Mental Health

Recommendation

Adopt a resolution authorizing the President of the Board to execute a performance agreement with the State Department of Mental Health.

Background

The 1991-92 state budget changed mental health funding from a state allocation system to sales tax funding with more local control. Section 5602 of the California Welfare and Institutions Code established a mandate for county performance agreements and replaced all previous agreements used between counties and the state. This Agreement includes various administrative assurances and program principles, a variety of local mental health programs, and reporting requirements for San Mateo County grant programs administered by the State.

Discussion

This agreement establishes administrative assurances and the County's commitment to implement local programs. The local programs include: Children's System of Care Initiative (CSOC); Integrated Services for Homeless Mentally Ill Adults; Program for Assistance in Transition from Homelessness (PATH); Substance Abuse and Mental Health Services Administration (SAMHSA) Grant Base Program and Dual Diagnosis; the Supportive Housing Initiative Act (SHIA); and mental health services to special education youth (government code chapter 26.5). This agreement has added language pertaining to the Health Insurance Portability and Accountability Act (HIPAA).

The administrative assurances in this Agreement require that the County report Client and Services Information (CSI) data to DMH within 60 days after month's end and make diligent efforts to minimize the error rate. The CSI error rate outcome for FY 2002-03 and objective for FY 2003-04 are as follows:

Performance Measure

FY 2002-03

FY 2002-03

FY 2003-04

Objective

Actual

Objective

Overall Client and Services Information System (CSI) error rate

Less than 1.0%

0.1%

Less than 1.0%

For the past two years the State Department of Mental Health (DMH) required collection of client intake and annual discharge data in order to report compliance with state standards for the Adult Performance Outcome System (APOS) and the Children and Youth Performance Outcome System (CPOS). That requirement was suspended for FY 2002-03 so that the State could plan and implement new reporting requirements for FY 2003-04. For FY 2003-04 a new set of mandated surveys were administered during two weeks in the fall to clients receiving services during that data collection period.

Until last year our performance agreement included our purchase/use of Napa State Hospital beds, which are now contracted separately. Your Board approved the agreement for the Napa State Hospital beds on April 6, 2004. This agreement is late because San Mateo and several other counties formally disputed the DMH requirement for an assurance that mental health services would be provided to special education youth even though full funding is not assured. This dispute has not been satisfactorily resolved, but this contract is recommended for approval, as state law mandates these services. Mental Health Services will continue to work with the California Mental Health Directors Association and CSAC to resolve this issue.

Vision Alignment

This Agreement with DMH 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 committing Mental Health Services to implementation and maintenance of a variety of local programs as well as Client Services Information (CSI) reporting.

Fiscal Impact

This Agreement does not provide allocation of funds for these programs. Funding allocations are contained in separate agreements with DMH. Should State funding for any of these programs be discontinued, we will not be obligated to meet the performance goals for the affected programs.