COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

BOARD MEETING DATE:

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health

Louise Rogers, Director, Behavioral Health & Recovery Services

SUBJECT:

Agreement with Telecare Corporation for Transitions Program

RECOMMENDATION:

Adopt a Resolution:

1) Authorizing the President of the Board to execute an Agreement with Telecare Corporation for Transitions Program services for the term July 1, 2008 through June 30, 2009 for a maximum obligation of $693,991; 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 supported housing and intensive case management services for mentally ill persons at risk of homelessness.

Behavioral Health and Recovery Services (BHRS) provides a range of services to promote wellness and recovery and to support consumers remaining in the lowest possible level of care. The provision of intensive case management is one established level of care. The services provided through this Agreement contribute to this measure.

Performance Measure:

Measure

FY 2007-08 Estimate

FY 2008-09 Target

Percentage of clients maintained at current or lower level of care.

65%

65%

BACKGROUND:

Since 2001 Telecare Corporation (Telecare) has contracted with BHRS to provide Transitions Program services for homeless mentally ill persons at the Department of Veterans Affairs campus in Menlo Park (VA). Program services include outreach, supported housing and intensive case management for mentally ill clients who are homeless or at risk of becoming homeless. Telecare also purchases interim housing for clients who do not reside at the VA. The Transitions Program initially served 79 homeless mentally ill adults and transition age youth. Juvenile Probation and the Human Services Agency may refer transition age youth to the program, including youth emancipating from foster care. An Agreement with the VA for the use of a building on their Willow Road campus to house this program was approved by your Board on June 6, 2006. Transitions clients typically receive services on a long-term basis, and remain enrolled in the program during episodes of hospitalization or incarceration. Telecare was selected to provide these services through a Request for Proposals process prior to FY 2007-08.

The FY 2007-08 State budget eliminated AB 2034 funding for these services. To ensure the health and safety of clients projected to be enrolled in the program, BHRS funded this program with Mental Health Services Act (MHSA) growth funds in FY 2007-08.

DISCUSSION:

The Agreement with Telecare is being renewed for FY 2008-09. Telecare provides outreach to individuals who are on the streets, who arrive at Psychiatric Emergency Services, or who are in homeless shelters. This outreach is critical to the successful enrollment of homeless mentally ill persons, many of whom have been unwilling or reluctant to use more traditional mental health services. Under this Agreement clients will receive pharmacy services through the BHRS pharmacy benefits management (PBM) provider. This Agreement also includes housing support services for up to four clients of the Pathways Program, which is funded by the Mentally Ill Offender Crime Reduction (MIOCR) grant. The Pathways Program, which provides gender−focused services to female mentally ill offenders using a wellness and recovery approach to treatment, will be provided only if the State renews MIOCR funding for FY 2008-09.

BHRS has two other agreements with Telecare. One is for the provision of services at Cordilleras Mental Health Center. A second Agreement is for Full Service Partnership services for adult and older clients which is a component of the County Mental Health Services Act three-year plan. BHRS anticipates folding the Transitions Program in with the Full Service Partnership services Agreement for FY 2009-10.

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 Agreement is July 1, 2008 through June 30, 2009. The Agreement maximum is $693,991, which is included in the BHRS FY 2008-09 Recommended Budget. Of that amount $470,491 will be funded by MHSA funds; MIOCR grant funds will provide $100,000; and State and Federal Medi-Cal and Medicare will fund $123,500. The total Transitions Program cost is $818,991, which includes Supplemental Security Income payments from program participants of $125,000. There is no Net County Cost.