COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

BOARD MEETING DATE:

December 9, 2008

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director, Health Department

Louise Rogers, Director, Behavioral Health & Recovery Services

SUBJECT:

Second Amendment to Agreement with Fred Finch Youth Center

RECOMMENDATION:

Adopt a Resolution Authorizing the President of the Board to execute a Second Amendment to the Agreement with Fred Finch Youth Center for mental health services for children and youth increasing the maximum obligation by $129,715 to a new maximum of $1,231,689, with no change to the term of July 1, 2007 through June 30, 2008.

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 Amendment to the Agreement contributes to this commitment and goal by providing Therapeutic Behavioral Services (TBS), Crisis In-Home Stabilization Program services, Visiting Therapist Program services, and Day Treatment services with associated outpatient mental health services to youth in order to maintain them in the least restrictive settings.

Performance Measure:

Measure

FY 2007-08
Actual

FY 2008-09
Projected

Clients maintained at current or lower level of care.

76%

76%

BACKGROUND:

Behavioral Health and Recovery Services (BHRS) has contracted with Fred Finch Youth Center for Crisis In-Home Stabilization Program services and TBS since 1999. On September 25, 2007, your Board approved an Agreement with this provider for the provision of Crisis In-Home Stabilization services, TBS, Day Treatment services, and outpatient Visiting Therapist Program services for the term of July 1, 2007 through June 30, 2008. Your Board also authorized the Director of Health to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000.

On August 14, 2008, the Director of Health approved an Amendment to the Agreement that increased the maximum obligation by $20,000 to a new maximum of $1,101,974. This increase was for additional authorized Visiting Therapist Program services.

DISCUSSION:

While the first Amendment was being planned, invoices were approved for authorized services that brought the cost of total payments in excess of the planned Amendment maximum. These invoices were mistakenly submitted to BHRS accounting for payment. Due to an accounting ledger formula error, this excess payment error was not discovered. These invoices were then approved and excess payments were made to the Contractor in the amount of $129,715. Because the error was not noted at that time, payment was made prior to the Agreement being amended. The majority of these additional services were for TBS, which are mandated for clients with full scope Medi-Cal. In order to reconcile our contracting process with the services that were provided and paid to date, this Amendment to the FY 2007-08 Agreement with Fred Finch increases the original Agreement maximum by $129,715 to a new maximum of $1,231,689. It is expected that the Contractor will reimburse the entire overpayment amount to BHRS through the cost report reconciliation process.

To safeguard against a recurrence of this overpayment, BHRS management has implemented the following contract invoice process changes: 1) program managers are being provided with monthly contract payment monitoring worksheets showing contract maximums and running balances; 2) individual general accounting ledgers have been reviewed to confirm that there are no additional formula errors; 3) BHRS Deputy Directors and program managers will receive quarterly payment reports for all contracts that are projected to exceed the agreement maximum; and 4) contracts staff will meet quarterly with accounting staff to compare their separate invoice spreadsheet totals.

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 Agreement remains July 1, 2007 through June 30, 2008. The maximum obligation for the amended Agreement is increased by $129,715 to a new maximum of $1,231,689. Of the increase, approximately $50,000 was included in the BHRS FY 2007-08 Adopted Budget, and the remaining $79,715 was included in the BHRS FY 2008-09 Adopted Budget. The entire cost of this increase is expected to be reimbursed by the Contractor through the cost report reconciliation process.