COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 15, 2005

BOARD MEETING DATE:

October 4, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health

Gale Bataille, Director of Mental Health Services

SUBJECT:

Agreement with Caminar

RECOMMENDATION:

Adopt a resolution:

A) Authorizing the President of the Board to execute an agreement with Caminar for the period July 1, 2005 through June 30, 2006, for a maximum obligation of $5,701,679;

B) Authorizing the President of the Board to approve a waiver of the request for proposal requirement process (RFP) for intensive case management; and

C) Authorizing the Director of Health to execute subsequent amendments and minor modifications not to exceed an aggregate of $25,000 and to make minor changes in the type of services and activities provided under the Agreement.

VISION ALIGNMENT:

Commitment: Ensure Basic Health and Safety for All

Goal 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 residential treatment, case management, rehabilitation services and community support services for mentally ill clients.

Performance Measures:

Measure

FY 2004-05
Actual

FY 2005-06
Projected

Minimum percentage of customer survey respondents who will rate services as good or better.

90%

90%

Transitional Residential Services: Percent of unduplicated clients discharged, after completion of 6 months or more of treatment, to more independent living.

* 74%

50%

*The objective standard for this program and service, system-wide is 50%. The 2004-05 actual is a measure of contractor success beyond the standard.

BACKGROUND:

Caminar is a recognized provider of residential treatment, rehabilitation services and community support services. San Mateo County has contracted with Caminar for over 25 years to provide services to psychiatrically disabled adult consumers. Without community based support services these mental health clients would be at significantly increased risk of psychiatric hospitalization, placement in a locked skilled nursing facility, or of becoming homeless.

DISCUSSION:

The services provided by Caminar include crisis residential treatment services, transitional residential treatment services, medication support, case management, intensive case management, and rehabilitation services for psychiatrically disabled adults. Case management, intensive case management, and rehabilitation services are designed to provide the level of support clients need to be successful in a variety of community living arrangements. Such services include supportive counseling, supported education and supported employment. Crisis residential services are provided at Redwood House and transitional residential services are provided at Eucalyptus House and Hawthorne House. Rates of reimbursement vary depending on the intensity of supervision and services provided.

Under the Mental Health Division’s plan for contracted services, residential and supportive services are included in the “any qualified provider” category. This category is used when there are a limited number of providers and the County is interested in all viable proposals. In this category any agency can submit a proposal at any time and the proposal will be evaluated on quality and cost factors. The only services under this Agreement subject to an RFP are intensive case management services.

Mental Health Services is requesting a one-year waiver of the RFP requirements for intensive case management services. Mental Health Services is engaged in an extensive and unprecedented planning process for new services as required by the Mental Health Services Act (MHSA), which will be completed Fall 2005. The results of this process are expected to impact the design of intensive case management services. The waiver is being requested in order for Mental Health Services to select contractors who would be best able to provide services in compliance with the results of the MHSA planning. The RFP for these services will be issued for FY 2006-07.

FISCAL IMPACT:

The term of this agreement is July 1, 2005, through June 30, 2006. The Agreement has been reviewed and approved by Risk Management and County Counsel.

Caminar was granted a 3% COLA for FY 2005-06 which is reflected in the Agreement maximum of $5,701,679. Federal and State Medi-Cal are expected to fund a total of $3,962,667. Substance Abuse and Mental Health Services (SAMHSA) will provide $48,340 in grant funding. Sales tax provided through realignment will cover $1,271,474. The net County cost is $419,198, which is included in the FY 2005-06 approved budget.