COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

December 12, 2006

BOARD MEETING DATE:

January 9, 2007

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:

Rates for Mental Health Services

RECOMMENDATION:

Adopt a resolution setting rates for Mental Health Services.

VISION ALIGNMENT:

Commitments: Ensure Basic Health and Safety for All and Responsive, Effective, and Collaborative Government.

Goals 8 and 20: Help vulnerable people–the aged, disabled, mentally ill, at risk youth, and others–achieve a better quality of life and Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain.

The approval of these rates contributes to these commitments and goals by establishing rates for mental health services.

Performance Measure:

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Percent change in third party revenues and client fees over prior year

-3%

5%

BACKGROUND:

Your Board has the authority to approve the rates for the Mental Health Services Division. These rates are used to establish the fees billed to clients and third party insurance companies for mental health services. The Mental Health Services Division is required to maintain rates at least equal to the standard maximum allowable (SMA) Medi-Cal rate established for each service by the State Department of Mental Health for FY 2006-07. Your Board approved rates for FY 2005-06 on December 6, 2005.

DISCUSSION:

The following rates for services provided by the Mental Health Services Division in FY 2006-07 are recommended for your Board’s approval. The rates are the greater of the SMA rate for each service for FY 2006-07 or the projected actual cost of each service. This schedule of recommended rates is late because the State maximum allowable rates were not released until October. The proposed rates for FY 2006-07 in the table below are effective as of July 1, 2006.

Schedule of Recommended Rates to Be Used to Establish Fees Billed to Clients and Third Party Insurance

Service

FY 2005-06

FY 2006-07

Day Treatment Intensive

$217.82 per day

$228.06 per day

Day Treatment Rehabilitative

$141.22 per day

$147.85 per day

Crisis Stabilization

$119.70 per hour

$131.61 per hour

Medication Support

$5.74 per minute

$6.34 per minute

Crisis Intervention

$4.76 per minute

$5.59 per minute

Case Management

$2.52 per minute

$2.69 per minute

Mental Health Services

$3.07 per minute

$3.43 per minute

Therapeutic Behavioral Services

$2.81 per minute

$2.94 per minute

In addition to direct billings to clients and third party insurance, which use the above rates, Mental Health Services also has numerous contracts with service providers for mental health services. Rates for those agreements are negotiated specific to each contractor and are approved in the contract approval process. When Mental Health Services negotiates renewal contracts for such services, rates are typically based upon the actual costs of the provider as identified in prior annual cost reports submitted to Mental Health Services.

FISCAL IMPACT:

The proposed rate schedule will yield a projected total of about $282,000 in client fees and third party insurance reimbursement in FY 2006-07. The revenues included in the FY 2006-07 Mental Health Services budget reflect these rates.