COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

 

DATE:

May 3, 2005

BOARD MEETING DATE:

June 7, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

 

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

   

SUBJECT:

Second Amendment to the Agreement with Santa Clara County

 

RECOMMENDATION:

Adopt a resolution authorizing the President of the Board to execute a second amendment to the agreement with Santa Clara County for two beds in the Correctional Treatment Center at the Santa Clara County Main Jail for inmate-patients requiring inpatient mental health treatment, extending the term of the agreement to be July1, 2004 – June 30, 2006 and increasing the amount by $912,000 bringing the total obligation to $1,737,000

 

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all

Goal(s) 8: Help vulnerable people – the aged, disabled, mentally ill, at-risk youth and others – achieve a better qualify of life.

 

The contract contributes to this goal by assuring that critical mental health care is provided.

 

Performance Measure(s):

Measure

FY 2004-05
Actual

FY 2005-06
Projected

Average daily bed use

1.4

1.2

 

BACKGROUND:

On June 29, 2004, your Board approved an agreement with Santa Clara County to provide one guaranteed bed in the Santa Clara County Main Jail for San Mateo County inmates requiring inpatient mental health treatment. This agreement was approved pending negotiations for a second guaranteed bed. The total amount of the initial agreement maximum was $800,000 for a one-year term from July 1, 2004 through June 30, 2005. On December 7, 2004 your Board approved an amendment to the agreement with Santa Clara County which provided a second guaranteed bed at the Correctional Treatment Center effective October 1, 2004 and increased the maximum amount to $825,000.

 

At final budget hearings in September 2004, the Health Department provided a report to your Board outlining options for inpatient mental health treatment services for jail inmates. These options were considered because Santa Clara County had increased its daily inpatient treatment rates from $166 per day to $1,190 per day beginning July 1, 2004. Historically, San Mateo County contracted for four guaranteed beds in the Santa Clara County Main Jail. Based on an analysis of the costs and risks associated with re-opening a treatment service in the County’s jail, the September report recommended that the County contract with Santa Clara County for two beds while enhancing Correctional Health staffing to reduce the need for inpatient treatment services at the Santa Clara Main Jail. Your Board approved the additional recommended staffing.

 

DISCUSSION:

The restructuring of mental health services in San Mateo County jails has allowed for expanded mental health coverage for suicide screening, outpatient treatment and behavior management. However, some of the most seriously mentally ill inmates still require involuntary inpatient treatment, usually for short periods of time. Correctional Health’s enhanced staffing approach assumed that there would be two guaranteed beds available in Santa Clara County to meet these inpatient treatment needs. The occupancy rate for the Santa Clara beds has averaged 1.7, although at any given time as many as four inmates have required acute care treatment.

 

FISCAL IMPACT:

The term of the agreement is July 1, 2004 to June 30, 2006. The agreement maximum is increased by $912,000 to $1,737,000, which is the net County cost of the agreement. The annual cost of each guaranteed bed is $434,350. The agreement maximum was set to also include costs associated with mandated court proceedings (e.g., Riese Hearings for forced medication, requiring attorney and paralegal time) and 60% of charges for any acute medical services (such as emergency hospitalization at Santa Clara Valley Medical Center) that may be required. The 2005-06 amount is $912,000 and is included in the recommended budget.