COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

November 16, 2004

BOARD MEETING DATE:

December 7, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Services

Gale Bataille, Director, Mental Health Services

SUBJECT:

Agreement with Caminar

Recommendation

Adopt a resolution:

A) Authorizing the President of the Board to execute an agreement with Caminar; and

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

Background

Caminar is a recognized provider of residential treatment, rehabilitation services and community support services. San Mateo County has contracted with Caminar for over 25 years to provide services to psychiatrically disabled adult consumers. Without community based support services these mental health clients would be at significantly increased risk of psychiatric hospitalization, placement in a locked skilled nursing facility, or of becoming homeless.

Discussion

The services provided by Caminar include crisis residential treatment services, transitional residential treatment services, medication support, case management, and rehabilitation services for psychiatrically disabled adults. Case management and rehabilitation services are designed to provide the level of support clients need to be successful in a variety of community living arrangements. Such services include supportive counseling, supported education and supported employment. Crisis residential services are provided at Redwood House and transitional residential services are provided at Eucalyptus House and Hawthorne House. Rates of reimbursement vary depending on the intensity of supervision and services provided.

Under the Mental Health Division’s plan for contracted services, residential and supportive services are included in the “any qualified provider” category. This category is used when there are a limited number of providers and the County is interested in all viable proposals. In this category any agency can submit a proposal at any time and the proposal will be evaluated on quality and cost factors.

Our County Manager has approved a waiver of the RFP process for intensive case management services based on the critical role Caminar’s REACH Program plays in reducing the number of administrative days for patients in the San Mateo Medical Center’s psychiatric inpatient unit. Issuance of an RFP would severely limit the Mental Health Division’s ability to work with Caminar to achieve planned savings. The RFP for these services will be issued for FY 2005-06.

The 2003-04 objectives and actual performance, and 2004-05 objectives are as follows:

Performance Measure

2003-04 Objectives

2003-04 Actual

2004-05 Objectives

Minimum percentage of client survey respondents who shall rate services as good or better*

90%

86%

90%

Case Management: Maximum percentage of clients who will spend more than 60 days in subacute facilities

10%

6%

10%

Transitional Residential: Maximum percentage of unduplicated clients who will be discharged to acute inpatient services

10%

9%

* n/a

Transitional Residential: Minimum percentage of clients discharged after completion of 6 months or more of treatment who will be discharged to more independent living.

* n/a

* n/a

50%

* FY 2004-05 Mental Health Services revised the performance measures for this Contractor.

Vision Alignment

This Agreement with Caminar 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 Agreement contributes to this commitment and goal by providing residential treatment, case management, rehabilitation services and community support services for mentally ill clients.

Fiscal Impact

The term of the agreement is July 1, 2004 through June 30, 2005. Caminar was granted a 1% COLA for FY 2004-05 which is reflected in the Agreement maximum of $5,147,422. Federal and State Medi-Cal are expected to fund a total of $3,578,476. Substance Abuse and Mental Health Services (SAMHSA) will provide $48,340 in grant funding. Sales tax provided through realignment will cover $1,148,297. The net County cost is $372,309, which is included in the FY 2004-05 approved budget.