COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

December 10, 2007

BOARD MEETING DATE:

December 18, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Gale Bataille, Director, Behavioral Health and Recovery Services

Lisa Mancini, Director of Aging and Adult Services

SUBJECT:

Agreement with Helios Healthcare, LLC

RECOMMENDATION:

Adopt a Resolution:

1)

Authorizing the President of the Board to execute an Agreement with Helios Healthcare, LLC for residential rehabilitation and long-term care services for the term July 1, 2007 through June 30, 2010 for a maximum obligation of $1,298,178; 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 Agreement with Helios Healthcare, LLC contributes to this commitment and goal by providing residential rehabilitation and long-term care for this vulnerable population of adults suffering from serious mental illness.

Performance Measure:

Measure

FY 2006-07
Actual

FY 2007-08
Projected

Percentage of discharges to an acute psychiatric level of care (lower is better).

0% *

25% *

* FY 06-07 performance exceeds target. The FY 07-08 target reflects the acuity of clients placed in this program.

BACKGROUND:

San Mateo County has contracted with Crestwood Behavioral Health, Inc. since 1988 for the provision of long-term care mental health services for County residents at multiple service sites, including their Idyllwood – Sunnyvale facility. In June 2007 Idyllwood – Sunnyvale came under the ownership of Helios Healthcare, LLC. Helios and Crestwood, while separate business entities, are operated by the same management team. Behavioral Health & Recovery Services (BHRS) became aware of this change in ownership in August, which necessitated a separate Agreement with Helios.

In October 2000 the gero-psychiatric unit at San Mateo Medical Center (SMMC) was closed. Some of the patients at SMMC were transferred to Crestwood facilities, including the Idyllwood – Sunnyvale facility. Some of these individuals are Lanterman, Petris and Short (LPS) mentally ill conservatees, and some are conserved under Probate dementia laws.

DISCUSSION:

To accommodate specialized treatment care needs and to distinguish between the LPS conserved mentally ill clients and the Probate dementia conservatees, this contract has a BHRS component and an Aging and Adult Services (AAS) component. The BHRS component provides services for up to 10 clients who are seriously mentally ill and in need of mental health rehabilitation, treatment and long-term care. The AAS component provides services for up to 6 clients who are Probate dementia conservatees and who require a locked, long-term treatment setting.

Services provided through this Agreement offer an alternative to use of more costly emergency services (i.e. Psychiatric Emergency Services, inpatient administrative days, and Corrections). Under the B-1 Administrative Memorandum, the selection of providers for these long-term locked facility services is exempt from the Request for Proposals requirement. This Agreement was initially late due to the late notice of change of ownership by the contractor. It has been further delayed due to the need to make changes to the services description as required by Helios.

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 this Agreement is July 1, 2007 through June 30, 2010. The Agreement maximum is $1,298,178. The three-year maximum for BHRS is $779,178. Funding for the BHRS component is 90% or $701,260 through sales tax realignment. The remaining $77,918 represents the Net County Cost for BHRS. These funds are included in the BHRS FY 2007-08 Adopted Budget. Similar arrangements will be made for FY 2008-09 and FY 2009-10.

The three-year maximum for AAS is $519,000. It is estimated that the cost for AAS for the first year will be $173,000, which is funded through client reimbursements and is included in the AAS FY 2007-08 Adopted Budget. There is no Net County Cost associated with the AAS component of this Agreement. Similar arrangements will be made for FY 2008-09 and FY 2009-10.