COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

August 31, 2007

BOARD MEETING DATE:

September 11, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health

Gale Bataille, Interim Director, Behavioral Health and Recovery Services

Brian Zamora, Director, Public Health and Environmental Protection Division

SUBJECT:

Agreement with Telecare Corporation at Cordilleras Mental Health Center

RECOMMENDATION:

Adopt a Resolution:

1)

Authorizing the President of the Board to execute an Agreement with Telecare Corporation for mental health services and directly-observed therapy services for non-adherent tuberculosis patients for the term July 1, 2007 through June 30, 2008, for a maximum obligation of $7,072,542; 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: 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 through the provision of inpatient and residential psychiatric treatment services and direct observation therapy for non-adherent tuberculosis (TB) patients at Cordilleras Mental Health Center.

Performance Measures:

Measure

FY 2006-07
Actual

FY 2007-08
Projected

Number of planned community discharges (MHRC*)

64**

89

Number of Psychiatric Emergency Services visits per month for Residential Program clients.

1.9***

No more than 4

*Mental Health Rehabilitation Center

**Mental Health will work with contractor to improve performance during FY 2007-08.

*** The performance for FY 2006-07 exceeds the target of “no more than 4.”

BACKGROUND:

Telecare Corporation has provided inpatient and residential psychiatric treatment services for San Mateo County residents at Cordilleras Mental Health Center in Redwood City since 1982. Telecare treats up to 110 seriously mentally ill San Mateo County residents through the operation of a locked MHRC and residential care services supported by an assertive treatment team. It also provides a direct observation therapy program for non-adherent TB patients and is the only facility in California to provide this service.

Over the last several years, Telecare has focused on increasing the number of admissions and discharges and shortening the average length of stay in its MHRC program to achieve cost reductions for out-of-county skilled nursing facilities placements and to reduce administrative days in the San Mateo Medical Center. Telecare was selected to provide these services through a Request for Proposals process prior to FY 2005-06.

DISCUSSION:

There are a total of 110 beds at Cordilleras dedicated to San Mateo County residents, of which 20 are residential beds for clients receiving intensive case management services and 67 beds which are part of the third floor’s licensed locked MHRC. This program serves 61 San Mateo County residents, with six beds reserved for clients of the Veterans Administration and other counties. Telecare also provides peer counseling for clients discharged from Cordilleras, as part of Mental Health’s Resource Management team. There is no service change for Telecare’s TB services.

The Agreement has been reviewed and approved by County Counsel and Risk Management. Real Property has reviewed and approved the License Agreement for use of the County-owned Cordilleras facility. 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. The Agreement with Telecare for these services is on the Continuing Resolution.

FISCAL IMPACT:

The term of this Agreement is July 1, 2007 through June 30, 2008. The Agreement maximum is $7,072,542.

For Mental Health Services, the Agreement maximum is $6,986,166, which is included in the Mental Health Services tentatively Adopted FY 2007-08 Budget. Medi-Cal will fund 5.2% or $363,281. Sales tax revenues provided through Realignment will pay $6,622,885. This funding includes a 3% COLA in order to fund negotiated labor agreements and sustain critical staffing required for intensive services to clients who would otherwise require out-of-county skilled nursing facility services or state hospital placement. There is no Net County Cost for the Mental Health funded services.

Public Health is required to pay a flat rate of $236 per day, or $86,376 per year, to reserve the TB bed for a client regardless of whether or not the bed is filled. The State TB Control Branch will award Public Health $86,376 for FY 2007-08 to cover this cost. Revenue and expenses related to this Agreement are included in the Public Health tentatively Adopted FY 2007-08 Budget. There is no Net County Cost for the Public Health funded services.