COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

March 19, 2007

BOARD MEETING DATE:

March 27, 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:

Amendment to the Agreement with Travis Svensson, M.D.

RECOMMENDATION:

Adopt a Resolution:

1) Authorizing the President of the Board to execute an Amendment to the Agreement for the provision of psychiatry services with Travis Svensson, M.D., to increase the maximum obligation by $125,000 to a new maximum of $150,000 for the period July 1, 2005 through June 30, 2008; and

2) Authorizing the Director of Health or the Director's designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate) and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.

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 Amendment to the Agreement contributes to this commitment and goal by providing psychiatric services for San Mateo County adults and adolescents at various mental health sites.

Performance Measure:

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Maximum percentage of clients re-admitted to hospital within 30 days of a completed episode of care.

13%

10%

BACKGROUND:

In March 1995 your Board approved the acceptance of State and Federal funds to implement the San Mateo County Managed Care Mental Health Plan (MHP). As part of this plan, the Mental Health Services Division offered contracts to any and all qualified and willing providers to provide mental health services to San Mateo County Medi-Cal clients, uninsured clients, and other clients for whom we have assumed responsibility.

On June 17, 2005 the Director of the Health Department approved an Agreement with Travis Svensson, M.D. for the provision of psychiatry services for the term of July 1, 2005 through June 30, 2008 for a maximum obligation of $25,000. In January 2006 the Mental Health Services Division became responsible for providing mental health services for all Health Plan of San Mateo (HPSM) CareAdvantage members. Services provided to these beneficiaries previously had been billed to Medicare. Since January 2006 the Mental Health Services Division has been developing new and amended agreements with the traditional provider pool for the provision of these services. Under the B-1 Administrative Memorandum, physicians are exempt from the requirement for a Request for Proposals process. Dr. Svensson joined our managed care provider network a few months after its inception in July 1995 and has continued as a provider of psychiatric services since that time.

DISCUSSION:

Dr. Svensson is one of a few MHP psychiatrists who provide inpatient and outpatient services to a considerable number of San Mateo County MHP clients. The volume of services Dr. Svensson provides for the new HPSM CareAdvantage members is substantial and necessitates an increase to our Agreement with him. This Agreement is being amended to increase the maximum by $125,000 to a new maximum of $150,000.

The Amendment also revises rates in Exhibit B of the Agreement, including the addition of new rates and the deletion of old rates, in order to be consistent with HPSM policy to match or exceed Medicare rates. Rates that are being carried forward have been increased by an average of thirty percent. These required increases result in no additional County costs as they are fully funded through State and Federal revenues. Under the B-1 Administrative memorandum physicians are exempt from the requirement for a Request for Proposals process.

The term of the amended Agreement remains July 1, 2005 through June 30, 2008. All other terms and conditions remain the same. The Amendment to the Agreement has been reviewed and approved by County Counsel and Risk Management.

The contractor has assured compliance with the County's Contractor Employee Jury Service Ordinance, as well as all other contract provisions that are required by County ordinance and administrative memoranda, including but not limited to insurance, hold harmless, non-discrimination and equal benefits.

FISCAL IMPACT:

The Agreement maximum is being increased by $125,000 to a new maximum of $150,000. Of that amount, $105,000 is funded by Medicare, $22,500 is funded by Federal Financial Participation, and $22,500 is funded by State Medi-Cal funds. For FY 2006-07 revenues and expenditures for these services are included in the Mental Health Services’ Adopted Budget. The balance of the revenues and expenditures will be included in the FY 2007-08 Recommended Budget. There is no Net County Cost.