COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

November 29, 2004

BOARD MEETING DATE:

December 7, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health Services

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreement with Sequoia Hospital and Medical Center

Recommendation:

Adopt a Resolution:

A) Authorizing the President of the Board to execute an agreement with Sequoia Hospital and Medical Center, and

B) Authorizing the Director of Health Services to execute subsequent amendments and minor modifications not to exceed an aggregate of $25,000 and to make minor changes in the types of services and activities provided under the Agreement.

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). Sequoia Hospital and Medical Center has contracted with the County to provide inpatient mental health services since 1995. These services are used when San Mateo Medical Center is full and occasionally when patients present directly to the Sequoia Hospital and Medical Center Emergency Department. For FY 2003-04 the Mental Health Services Division contracted with Mills-Peninsula Hospitals, St. Mary’s Hospital and Medical Center and Mt. Diablo Medical Pavilion to provide inpatient 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, and is again contracting with Sequoia Hospital and Medical Center. The agreement with Mills-Peninsula Hospitals will be presented to your Board once we have received necessary insurance documents and the signed agreement.

This agreement with Sequoia Hospital and Medical Center contains rates for inpatient mental health services for Medi-Cal-covered adults and rates for inpatient mental health services for uninsured adults for FY 2004-05. Administrative Day rates, which are reimbursed based on the rate set by the state, are also included. 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 total maximum amount for all four hospitals agreements, collectively, is $882,411. There are no separate contract maximums for individual hospitals.

County Counsel has reviewed and approved the agreement and Risk Management has approved the insurance coverage.

The negotiated rate schedule is below:

Daily Inpatient

Daily Inpatient

Administrative

Medi-Cal Rate

Uninsured Rate

Day Rate

FY 2004-05

FY 2004-05

FY 2004-05

$580.00

$610.00

$296.03

Objective and actual performance for FY 2003-04 and the objective for FY 2004-05 are below:

Performance

2003-04

2003 -04

2004-05

Measure

Objective

Actual

Objective

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

10% or less

8%

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 inpatient mental health services for San Mateo County youth and adults.

Fiscal Impact

The agreement is effective July 1, 2004 through June 30, 2005 and carries a 30-day termination clause for both parties. The agreement maximum is $882,411. Of that amount, $635,336 will be funded with state and federal Medi-Cal funds, $160,599 will be funded with realignment funds, $17,648 is funded through Health Plan of San Mateo insurance, and the remaining $68,828 is the net County cost. Funding for this agreement has been included in the FY 2004-05 approved Mental Health Services budget.