COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

May 22, 2006

BOARD MEETING DATE:

June 20, 2006

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Nomalee Tilman, Director, Correctional Health

SUBJECT:

Agreement with Santa Clara County

RECOMMENDATION:

Adopt a resolution:

A)

Waiving the Request for Proposal requirement; and

B)

Authorizing the President of the Board to execute an Agreement with Santa Clara County for two beds in the Santa Clara Main Jail for inmate-patients for the term of July 1, 2006 through June 30, 2008, for a total obligation not to exceed $2,000,000.

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 quality of life.

The contract contributes to this goal by assuring that critical inpatient mental health care is provided to inmates of San Mateo County jails.

Performance Measure(s):

Measure

FY 2005-06
Projected

FY 2006-07
Projected

Average daily bed use

1.03

1.10

BACKGROUND:

From 1997 through June 2004, the Health Department contracted with Santa Clara County to provide four beds in their main jail for inmates requiring inpatient mental health treatment. In response to a significant increase in the rates charged for this service, the number of guaranteed beds was reduced to one in an agreement approved by your Board, Resolution 066732, for a total maximum amount of $800,000 for a one-year term from July 1, 2004 through June 30, 2005. On December 7, 2004, by Resolution 067063 your Board approved an amendment to that agreement which provided a second guaranteed bed at the Santa Clara Correctional Treatment Center effective October 1, 2004 and increased the maximum amount to $825,000. On June 7, 2005, by Resolution 067344 your Board approved a second amendment to the agreement with Santa Clara County, extending the term of the agreement to June 30, 2006 and increasing the total obligation to $1,727,000.

DISCUSSION:

The occupancy rate for the Santa Clara beds has averaged 1.03 beds per day this year, although at any given time as many as four seriously mentally ill inmates have required acute care inpatient treatment. The restructuring of mental health services in San Mateo County jails has allowed expansion of mental health coverage for suicide screening, outpatient treatment and behavior management and a reduction in the number of contracted beds from the original four. Though average bed use has been just over one bed per day this year, psychiatrists in both Mental Health and Correctional Health Services believe that contracting for only one bed poses an unacceptable risk and that the second bed must be available as a safety net.

A waiver of the Request for Proposals requirement is requested as Santa Clara County is the only provider of this service in the Bay Area. They have been providing this service to San Mateo County’s seriously mentally ill inmates since 1997.

County Counsel has reviewed and approved the agreement. The agreement, which is the Santa Clara County standard form agreement, is the provider’s agreement, not our own.

FISCAL IMPACT:

The term of this agreement is July 1, 2006 to June 30, 2008. The agreement maximum is $2,000,000, which is the Net County Cost of the agreement. The cost of two guaranteed beds for 365 days at a rate of $1,250 per bed per day is $912,500 for the period July 1, 2006 through June 30, 2007. With a 5% COLA in effect for the second year, the cost of two guaranteed beds for 366 days at a rate of $1,313 per bed per day is $961,116 for the period July 1, 2007 through June 30, 2008. 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 costs for this agreement are included in the recommended budgets for FY 2006-07 and FY 2007-08.