COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

September 5, 2008

BOARD MEETING DATE:

September 30, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Lisa Mancini, Director, Aging and Adult Services

SUBJECT:

Amendment Three to the Agreement with Telecare Corporation

RECOMMENDATION:

Adopt a Resolution authorizing the President of the Board to execute Amendment Three to the Agreement with Telecare Corporation for residential rehabilitation and long-term care services increasing the amount by $320,000 to $7,804,687 for the term July 1, 2007 through June 30, 2009.

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 Telecare Corporation keeps the commitment to ensure basic health and safety for all by providing residential rehabilitation and long-term care for adults suffering from dementia, neurobehavioral, and other cognitive disorders due to a general medical condition.

The Health Department has multiple contracts with Telecare for long-term residential care services, the Full Service Partnership (FSP) program, and the Transitions program. Each of these programs contributes to the Health Department’s goal of assisting clients in remaining in the lowest level of care as safely possible. The provision of locked facility long-term care services for clients with brain injuries is one established level of care.

Performance Measure:

Measure

FY 2007-08
Actual

FY 2008-09
Estimated

Number of Public Guardian Program conserved clients with severe behavioral issues associated with brain damage effectively placed at a lower level of care.

2

2

BACKGROUND:

On May 4, 2006, Agreement 61000-06-C262 was approved by the County Manager for FSP for the highest risk adults and older adults in the amount of $100,000 for the term April 16, 2006 through June 30, 2006. By Resolution 68075, Amendment One to this Agreement was approved by your Board to continue FSP, increase the amount by $4,138,459 to $4,238,459, and extend the term through June 30, 2008.

On January 29, 2008, by Resolution 69229, your Board approved Amendment Two to the Agreement adding Outreach and Support Services and Housing Support services for FSP enrollees; increasing the amount by $3,246,228 to $7,484,687; and extending the term June 30, 2009.

DISCUSSION:

This Third Amendment to the Agreement with Telecare provides residential rehabilitation and long-term care at one of the Telecare facilities for Public Guardian program conserved clients with severe behavioral issues associated with brain damage.

Aging and Adult Services (AAS) has a Memorandum of Agreement (MOA) with Telecare’s Garfield Neurobehavioral Center facility to provide care and placement to Public Guardian program conserved clients with severe behavioral issues associated with brain damage. These clients are not able to be placed at other facilities that the County currently has agreements with due to behaviors that require additional care and supervision. The Telecare Garfield Neurobehavioral Center specializes in brain injuries and is able to meet the needs of clients with more severe behavioral issues. Without placement at Garfield Neurobehavioral Center, these clients could only be placed in the San Mateo Medical Center’s acute psychiatric unit, a more expensive placement for the County. This Third Amendment to the Agreement formalizes the MOA through a County Agreement.

Services provided through this Amendment with Telecare are paid for through Medi-Cal Patch funds (funds above the amount of Medi-Cal reimbursement). 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.

The Amendment 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:

Amendment Three to the Agreement with Telecare Corporation is for the provision of long-term care health services, increasing the maximum amount by $320,000 for a new total amount of $7,804,687. The additional $320,000 is included in the AAS tentatively Adopted FY 2008-09 Budget. There is no additional Net County Cost associated with this action.