COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

November 28, 2005

BOARD MEETING DATE:

December 13, 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 Telecare Corporation for Transitions Program

RECOMMENDATION:

Adopt a Resolution:

1)

Waiving the Request for Proposal process;

2)

Authorizing the President of the Board to execute an agreement with Telecare Corporation for the term July 1, 2005 through June 30, 2006 for a maximum obligation of $1,192,274; and

3)

Authorizing 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.

VISION ALIGNMENT:

Commitment: to 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.

This agreement contributes to this commitment and goal by providing supported housing and intensive community treatment for mentally ill persons who are homeless.

Performance Measures:

Measure

FY 2004-05
Actual

FY 2005-06
Projected

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

86%

85%

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

84%

85%

BACKGROUND:

In February 2001, your Board accepted AB 2034 grant funding in order 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.

DISCUSSION:

The Health Department is renewing the 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, who arrive at Psychiatric Emergency Services or who are in homeless shelters. This outreach is critical to the successful enrollment of homeless mentally ill persons, many of whom 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.

Since 1999 Mental Health Services has contracted for residential and supported housing services under its plan for contracting, which excludes these services from the Request for Proposals requirement. County Counsel has advised that our plan should be updated and presented to your Board for approval, which we will do in early 2006. Given the significant and ongoing shortage of these services available for Mental Health clients, we are requesting that the Request for Proposal requirement be waived for the agreement with this provider. This agreement has been reviewed and approved by both County Counsel and Risk Management.

The Health Department has another agreement with Telecare for the provision of mental health services and for tuberculosis treatment at Cordilleras Mental Health Center. That agreement will be presented to your Board separately.

FISCAL IMPACT:

The agreement term is from July 1, 2005 through June 30, 2006. The total program cost is $1,375,070, less member SSI payments covering $182,796. The Agreement maximum is $1,192,274, which is included in the approved FY 2005-06 Mental Health Services budget. This is an increase of $43,000 over the FY 2004-05 agreement. AB 2034 grant funds will reimburse $914,400. The balance of $277,874 will be funded by state and federal Medi-Cal. There is no Net County Cost.