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COUNTY OF SAN MATEO
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Inter-Departmental Correspondence
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Health Department
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DATE:
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May 12, 2008
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BOARD MEETING DATE:
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May 20, 2008
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SPECIAL NOTICE/HEARING:
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None
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VOTE REQUIRED:
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Majority
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TO:
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Honorable Board of Supervisors
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FROM:
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Charlene A. Silva, Director of Health
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Louise Rogers, Director of Behavioral Health and Recovery Services
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SUBJECT:
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Agreement with 7th Avenue Center, LLC
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RECOMMENDATION:
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Adopt a Resolution:
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1) Authorizing the President of the Board to execute an Agreement with 7th Avenue Center, LLC, to provide locked psychiatric care for clients of Behavioral Health and Recovery Services for the term July 1, 2008 through June 30, 2011, for a maximum obligation of $1,040,250; and
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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.
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VISION ALIGNMENT:
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Commitment: Ensure basic health and safety for all.
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Goal 8: Help vulnerable people—the aged, disabled, mentally ill, at-risk youth, and others—achieve a better quality of life.
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The Agreement contributes to this commitment and goal by providing locked psychiatric care for San Mateo County adults with serious and persistent mental illness.
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Performance Measure:
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Measure
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FY 2007-08
Actual
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FY 2008-09
Projected
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Percentage of clients maintained at current or lower level of care.
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79%*
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79%
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* These data are for all contractors providing locked long-term care services.
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BACKGROUND:
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Mental Health Rehabilitation Centers (MHRC) such as 7th Avenue Center, LLC, (7th Avenue) provide locked psychiatric care for adults with serious and persistent mental illness. Counties are required by the State Department of Mental Health to pay a “basic rate” for skilled nursing/basic care for adults 18-64 years of age who are housed in MHRC facilities. The basic rates vary by geographic region and are set annually by the State Department of Health Services. Medi-Cal provides basic rate funding for individuals in locked facilities who are age 65 years and older. In addition to the basic rate, selected San Mateo County clients at MHRC facilities may be authorized for supplemental payments, often referred to as “patches” or “enhanced rates” in order to provide augmented services based on the severity of an individual’s illness. 7th Avenue has contracted with Behavioral Health and Recovery Services (BHRS) since 2002. Your Board last approved a resolution for the term July 1, 2005 through June 30, 2008. 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.
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DISCUSSION:
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BHRS is renewing the Agreement with 7th Avenue for the provision of five beds for San Mateo County residents. Efforts over the last several years to decrease the length of stay at Napa State Hospital and at Cordilleras have resulted in an increased use of community placements like 7th Avenue. For severely mentally ill clients, 7th Avenue is a less expensive alternative placement than Napa State Hospital. The daily rate at the State Hospital is $346.68 versus $190 at 7th Avenue. 7th Avenue has been willing to work with clients with very difficult behavioral problems who are placed directly from the State Hospital. In addition, this facility has a women’s wing with all female staff for female clients in need of a gender specific program.
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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 Services 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.
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FISCAL IMPACT:
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The term of the Agreement is July 1, 2008 through June 30, 2011. The Agreement maximum is $1,040,250 for the three-year term. The budgeted maximum for FY 2008-09 is $346,750 which has been included in the BHRS FY 2008-09 Recommended Budget. Of that amount, sales tax through Realignment will fund $308,608 and the remaining $38,142 represents Net County Cost. Similar arrangements will be in place for FY 2009-10 and FY 2010-11.
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