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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 13, 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 of Health
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Gale Bataille, Director of Mental Health Services
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Brian Zamora, Director, Public Health Services
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SUBJECT:
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Agreement with Telecare Corporation for services at Cordilleras Mental Health Center
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RECOMMENDATION:
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Adopt a resolution authorizing:
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1)
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The President of the Board to execute an agreement with Telecare Corporation for the term July 1, 2005 through June 30, 2007, for a maximum obligation of $13,575,865; and
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2)
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The Director of Health to execute subsequent amendments and minor modifications not to exceed $25,000 in aggregate and to make minor changes in the types of services and activities provided under the agreement.
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VISION ALIGNMENT:
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Commitment: To ensure basic health and safety for all.
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Goal 8: Help vulnerable people - the aged, disabled, mentally ill, at risk youth, and others - achieve a better quality of life.
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This Agreement contributes to this commitment and goal through the provision of inpatient and residential psychiatric treatment services and direct observation therapy for non-adherent Tuberculosis patients at Cordilleras Mental Health Center
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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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Number of admissions (MHRC)
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95
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132
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Number of planned community discharges (MHRC)
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84
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89
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Number of Psychiatric Emergency Services visits per month for Residential Program clients.
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3.5
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No more than 4
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BACKGROUND:
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Telecare Corporation has provided inpatient and residential psychiatric treatment services for San Mateo County residents at Cordilleras Mental Health Center in Redwood City since 1982. Telecare treats up to 110 seriously mentally ill San Mateo County residents through the operation of a locked Mental Health Rehabilitation Center (MHRC) and residential care services supported by an assertive treatment team. It also provides a direct observation therapy program for non-adherent Tuberculosis patients.
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Over the last two years Telecare has focused on increasing the number of admissions and discharges, and shortening the average length of stay in its MHRC program, permitting reductions in spending for beds in out-of-county psychiatric skilled nursing facilities, and reducing administrative days in the San Mateo Medical Center’s psychiatric inpatient unit.
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DISCUSSION:
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In June of 2005 the Health Department released a Request for Proposals for services at Cordilleras Mental Health Center; Telecare was the only respondent.
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There are a total of 110 beds at Cordilleras dedicated to San Mateo County residents. The first and second floors of Cordilleras provide 49 residential beds for San Mateo County clients. On the first floor Magnolia and Edgewood Suites provide 29 residential beds. Willow Suites on the second floor provides 20 residential beds with intensive case management services. The third floor has 67 beds and is licensed as a locked Mental Health Rehabilitation Center (MHRC). This program serves 61 San Mateo County residents and reserves 6 beds for the Veterans Administration and other counties. Telecare also provides peer counseling for clients discharged from Cordilleras, as part of Mental Health’s Resource Management team.
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FISCAL IMPACT:
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The term of this agreement is July 1, 2005 through June 30, 2007. The agreement maximum for the two-year period is $13,575,865, with the maximum amount for FY 2005-06 being $6,689,156. The agreement with Telecare is currently on the continuing resolution.
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For Mental Health Services, the agreement maximum is $13,367,815 for the two-year term. For FY 2005-06 $6,585,131 is included in the Adopted Budget. State and federal Medi-Cal will fund 4.1% or $272,274. Sales tax revenues provided through Realignment will pay $5,626,686. For FY 2006-07 the Mental Health maximum will be $6,782,684, which includes a 3% COLA in order to fund negotiated labor agreements and sustain critical staffing required for intensive services to clients who would otherwise require out-of-county skilled nursing facility services or state hospital placement. Net County Cost is $686,171 as maintenance of effort for Realignment.
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Public Health is required to pay a flat rate of $105 per day to reserve the TB bed for a client regardless of whether or not the bed is filled, or $38,325 per year. If the bed is filled, the day rate doubles to $210. If medications are required, an additional $75 per day may be charged to Public Health. The total amount included in the agreement for two years is $208,050; this amount is enough to cover maximum charges for one TB client for two years. The State TB Control Branch has awarded Public Health $76,650 for FY 2005-06 to cover the flat day rate. If the bed is filled, the State will reimburse Public Health for the additional charges. Expenses related to this Agreement are included in the Public Health adopted budgets for FY 2005-06 and FY 2006-07. There is no Net County Cost associated with the Public Health portion of this Agreement.
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