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. Dr. Gurevitz joined our managed care provider network a few months after its inception in July 1995 and has continued as a provider of psychiatry services since that time. On June 29, 2005, the County Manager approved an Agreement with Dr. Gurevitz to provide psychiatry services for the term July 1, 2005 through June 30, 2008, for a maximum obligation of $99,000. |
In January 2006 Mental Health Services 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 Mental Health Services has been developing new and amended agreements with the traditional provider pool for the provision of these services. |
DISCUSSION: |
Dr. Gurevitz 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. Gurevitz provides for the new HPSM CareAdvantage members is substantial and necessitates an Amendment to increase the Agreement maximum. 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 30%. 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 $51,000 to a new maximum of $150,000 for the period July 1, 2005 through June 30, 2008. Of that amount, $105,000 is from Medicare, $22,500 is from Federal Financial Participation, and $22,500 is from State Medi-Cal funds. Revenues and expenditures for these services are included in the Mental Health Services’ FY 2006-07 Adopted Budget. The balance of the revenues and expenditures are included in the FY 2007-08 Recommended Budget. There is no Net County Cost. |