COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 14, 2007

BOARD MEETING DATE:

September 25, 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 & Recovery Services

SUBJECT:

Agreement with Lena Osher, M.D.

RECOMMENDATION:

Adopt a Resolution:

1) Authorizing the President of the Board to execute an Agreement with Lena Osher, M.D. for psychiatric services for the term July 1, 2007 through June 30, 2009, for a maximum obligation of $391,384; 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 Agreement contributes to this commitment and goal by providing psychiatric services for children and youth at Canyon Oaks Youth Center (COYC).

Performance Measure:

Measure

FY 2006-07
Actual

FY 2007-08
Projected

Percentage of clients satisfied with services received

40%*

90%

*Many COYC clients are placed by court order. Satisfaction data from COYC is typically lower than other service sites. Five clients provided satisfaction data for this measure. Mental Health will monitor contractor performance and client satisfaction during the Agreement term.

BACKGROUND:

There has been a shortage of adult and child psychiatrists in California and in the nation for the past several years. Mental Health Services has found it extremely difficult to fill adult and child psychiatrist positions. Under Administrative Memorandum B-1, agreements with physicians are exempt from the requirement for a Request for Proposals process. Mental Health Services runs advertisements for specialty psychiatric services on a regular basis in the Northern California Psychiatric Newsletter and other venues as needed. Dr. Osher was selected from candidates who responded to those advertisements in 2003 and has contracted with Mental Health Services since that time.

DISCUSSION:

Dr. Osher will provide psychiatric services for children and youth at COYC for a two-year term. The services shall include child and youth medication evaluation and treatment, psychotherapy, family consultation, and case consultation to staff.

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. This Agreement is on the Continuing Resolution.

FISCAL IMPACT:

Contracted psychiatrists are usually offered a rate increase that matches the negotiated COLA’s provided to physicians at the San Mateo Medical Center (SMMC). This Agreement was put in place prior to the completion of negotiations between the Union of Physicians and Dentists and SMMC this year. For this Agreement a 3% rate increase has been included for both FY 2007-08 and FY 2008-09.

The term of the Agreement is July 1, 2007 through June 30, 2009. The Agreement maximum is $391,384 for the two-year term. For FY 2007-08 the budgeted maximum is $192,800, which has been included in the Mental Health Services tentatively Adopted FY 2007-08 Budget. Of that amount, State and Federal Medi-Cal revenue will fund $96,400, AB3632 will fund $32,776, the Human Services Agency will fund $9,640, and sales tax through realignment will fund $28,920. Net County Cost will fund $25,064. Similar arrangements will be made for FY 2008-09.