COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

October 5, 2007

BOARD MEETING DATE:

October 16, 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:

First Amendment to the Agreement with Deval Shah, M.D.

RECOMMENDATION:

Adopt a Resolution:

1) Authorizing the President of the Board to execute an Amendment to the Agreement with Deval Shah, M.D. for the provision of psychiatric services, extending the term through June 30, 2009, and increasing the maximum obligation by $489,864 to a new maximum of $514,864; 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.

This amended Agreement contributes to this commitment and goal by providing psychiatric services for youth at various Mental Health Services sites.

Performance Measure

Measure

FY 2006-07
Actual

FY 2007-08
Projected

Percentage of clients satisfied with Contractor services.

N/A*

90%

* Contractor is a new provider for Mental Health Services.

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. Shah was selected from candidates who responded to those advertisements in 2007.

On August 30, 2007, by Agreement 61000-08-D006, the Director of Health approved an Agreement with Deval Shah, M.D. for the term September 1, 2007 through October 31, 2007, for a maximum obligation of $25,000. Under the original Agreement Dr. Shah provided psychiatric services for at-risk youth in the County Mental Health system, including the Primary Care Interface sites, Therapeutic Day Schools, and Regional Clinics. Due to clinical needs in Mental Health, the original Agreement for these services needed to be in place by September 1, 2007. To accommodate that need, the original Agreement was submitted under the authority of the Director of Health with the expectation that it would be amended to extend the term through June 30, 2009 and to add additional funding.

DISCUSSION:

Mental Health Services is amending the Agreement with Dr. Shah to extend the term through June 30, 2009, and to increase the Agreement maximum by $489,864, to a new maximum of $514,864. Dr. Shah will provide psychiatric services for at-risk youth at a variety of Mental Health Services program sites.

Contracted psychiatrists are offered rate increases that match the negotiated rate increases for psychiatrists at the San Mateo Medical Center (SMMC). In order to match these rates a 5.8 percent increase is being added to this Agreement for FY 2007-08. An additional 3 percent increase is added for FY 2008-09.

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 term of the amended Agreement is September 1, 2007 through June 30, 2009. The Agreement maximum is being increased by $489,864 to a new maximum of $514,864. For FY 2007-08 the budgeted maximum is $243,341, which has been included in the Mental Health Services’ FY 2007-08 Adopted Budget. State and Federal Medi-Cal revenue will fund 100% of the cost. There is no Net County Cost. Similar arrangements will be made for FY 2008-09.