Inter-Departmental Correspondence

Health Services Agency



November 29, 2004


December 14, 2004



Honorable Board of Supervisors


Charlene A. Silva, Director of Health Services

Gale Bataille, Director of Mental Health Services


Agreement with Telecare Corporation for Transitions Program



Adopt a Resolution:


Authorizing the President of the Board to execute an agreement with Telecare Corporation; and


Authorizing the Director of the Health Services Agency 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.



In February 2001, your Board accepted the AB 2034 grant funding to implement a program for homeless mentally ill persons, and approved a five-year lease with the Department of Veterans Affairs, Palo Alto Health Care System (VAPAHCS) to provide space for housing for up to 40 homeless individuals. Since 2001 Telecare has provided the services portion of this program, known as the Transitions Program. This program includes supported housing services at VAPAHCS and an intensive community treatment team known as the Assertive Community Treatment (ACT) team that serves mentally ill clients who are homeless or at risk of becoming homeless. In addition, the Transitions Program purchases interim housing resources for clients who do not reside at the VAPAHCS. The Transitions Program serves 75 homeless mentally ill adults and transition age youth.



Health Services is renewing this agreement with Telecare to provide services for up to 65 adults and 10 transition youth who are seriously and persistently mentally ill, and are homeless or at immediate risk of becoming homeless. Program participants may have co-occurring drug and alcohol problems. The ACT team functions as the point of entry to the program, providing outreach to individuals who are on the streets, and arrive at Psychiatric Emergency Services or are in homeless shelters. This outreach is critical to the successful enrollment of homeless mentally ill persons, many of who have been unwilling or reluctant to use more traditional mental health services. Juvenile Probation and Human Services may refer transition age youth to the program, including youth emancipating from foster care.


Under this agreement clients will receive pharmacy services through the Mental Health Pharmacy Benefits Management (PBM) provider.


Health Services has another agreement with Telecare, for the term July 1, 2003 through June 30, 2005. That agreement is for the provision of mental health services and for Tuberculosis Treatment Services at Cordilleras Mental Health Center.


This agreement has been reviewed and approved by both County Counsel and Risk Management.


Performance Measures

2003-04 Objective

2003-04 Actual

2004-05 Objective

Reduction of total days of psychiatric hospitalization for enrolled program clients in comparison to total days enrolled 12 months prior.




Reduction of total days of incarceration for enrolled program clients in comparison to total days enrolled 12 months prior.





Vision Alignment

This agreement with Telecare Corporation 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 supported housing and intensive community treatment for mentally ill persons who are homeless.


Fiscal Impact

The agreement term is from July 1, 2004 through June 30, 2005. The total program cost is $1,324,522, less member SSI payments covering $175,248. The Agreement maximum is $1,149,274, which is included in the approved FY 2004-05 Mental Health Services budget, and is the same as the FY 2003-04 agreement maximum amount. The AB 2034 grant funds will reimburse $832,386 and the balance of $316,888 will be funded by State and federal Medi-Cal. There is no net County cost.