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COUNTY OF SAN MATEO
Inter-Departmental Correspondence
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Health Department
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DATE:
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November 28, 2005
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BOARD MEETING DATE:
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December 6, 2005
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director, Health Department
Barbara Pletz, EMS Administrator
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SUBJECT:
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San Mateo County Mental Assessment and Referral Team
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RECOMMENDATION:
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1. Adopt a resolution authorizing the President of the Board of Supervisors to execute an Agreement with American Medical Response West (AMR) for response and assessment of individuals having behavioral emergencies in the field setting and prescheduled transportation of clients of the Mental Health or Aging and Adult Services Divisions for the purposes of court hearings, evaluations or trials for the term of December 7, 2005 through December 31, 2008 in the amount of $1,134,000; and waiving the request for proposals process.
2. Adopt a resolution authorizing AMR paramedics who have completed a county-approved training program to place a 72-hour hold in accordance with Section 5150 of the Welfare and Institutions Code.
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VISION ALIGNMENT:
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Commitment: Ensure Basic Health and Safety for All.
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Goal(s) 5: Residents have access to healthcare and preventative care.
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This contract contributes to the goal by improving emergency services provided to people having behavioral emergencies in the field setting.
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Performance Measure(s):
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Measure
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FY 2004-05
Actual
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FY 2005-06
Projected
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Percent of EMS responses to behavioral emergencies by AMR “SMART” vehicle
*New program insufficient data to project with accuracy.
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0%
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70%*
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BACKGROUND:
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Section 5150 of the Welfare and Institutions Code specifies that when a person, as a result of a mental disorder, is a danger to him or herself or others, or is gravely disabled, he or she be placed in custody and taken to a facility designated by the County for 72-hour treatment and evaluation. Peace officers and other personnel specifically designated by the County may place individuals on this 5150 hold.
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The County currently has a contract with AMR to provide the Code 2 ambulance response and transport of individuals on 5150 holds as well as prescheduled transportation of clients of the Mental Health or Aging and Adult Services Divisions for the purposes of court hearings, evaluations, or trials. This contract expires December 31, 2005. AMR was chosen to provide these contract services in response to an RFP.
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DISCUSSION:
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The new agreement continues to include transportation for prescheduled transport of clients of the Mental Health and Aging and Adult Services Divisions for the purposes of court hearings, evaluations or trials. It also adds the “San Mateo County Mental Assessment and Referral Team” (SMART) program.
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SMART is a new program developed by the Health Department and American Medical Response West (AMR) in which a specially trained paramedic will respond to law enforcement Code 2 EMS requests for individuals having a behavioral emergency. This SMART paramedic will be able to perform a mental assessment, place a 5150 hold if needed and transport the client to psychiatric emergency services, or, in consultation with County staff, arrange for other services to meet the individual’s needs. Access to the new SMART program will only be through the County’s 9-1-1 system.
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A waiver to the RFP process is recommended for this contract because AMR already provides countywide ambulance service and is the only company providing a similar paramedic mental health technician program in another California county.
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FISCAL IMPACT:
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The maximum contract amount is $1,134,000 for the term of the Agreement. Costs associated with this contract for FY 2005-06 will be $324,000 and were included in the approved Emergency Medical Services (EMS) budget for FY 2005-06. The sources of this funding are Mental Health Division ($100,000), Aging and Adult Services ($100,000), and Health Administration ($124,000). There is no Net County Cost associated with this Agreement. The term of the Agreement is December 7, 2005 through December 31, 2008.
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