COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Services Agency

DATE:

November 29, 2004

BOARD MEETING DATE:

December 14, 2004

TO:

Honorable Board of Supervisors

FROM:

Charlene A. 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:

A) Authorizing the President of the Board to execute an agreement with St. Mary’s Hospital and Medical Center, and

B) Authorizing the Director of Health Services to execute subsequent amendments and minor modifications not to exceed the 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). St. Mary’s Hospital and Medical Center has contracted with the County to provide inpatient mental health services since 1995. St. Mary’s services are used when inpatient capacity for adolescents is required. 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 Hospital, St. Mary’s Hospital and Medical Center, and Mt. Diablo Medical Pavilion and is again contracting with Sequoia Hospital and Medical Center, which was a non-contract mental health services provider for FY 2003-04. The agreements with Mt. Diablo for FY 2004-06 and Sequoia Hospital and Medical Center for 2004-05 have already been presented to your Board.

This agreement with St. Mary’s Hospital and Medical Center contains rates for inpatient mental health services for Medi-Cal-covered patients and rates for inpatient mental health services for uninsured youth 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 for FY 2004-05, 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

13%

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 the Health Plan of San Mateo, 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.