Inter-Departmental Correspondence

Health System



February 5, 2009


March 3, 2009







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


Louise Rogers, Director, Behavioral Health and Recovery Services



Agreement with A & C Health Care Services, Inc. dba Millbrae Manor



Adopt a Resolution:

1) Authorizing the President of the Board to execute an Agreement with A & C Health Care Services, Inc. dba Millbrae Manor for the provision of board and care services, for the term July 1, 2008 through June 30, 2010, for a maximum obligation of $253,310; and


2) Authorizing the Chief of the Health System or the Chief’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.



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 contributes to this commitment and goal by providing residential board and care services to mentally ill clients.


Behavioral Health and Recovery Services provides a range of services in order to promote wellness and recovery and to support consumers at the lowest possible level of care. The provision of residential board and care services to mentally ill clients is one established level of care. The services provided through this Agreement contribute to this measure.


Performance Measure:


FY 2007-08

FY 2008-09

Percentage of client survey respondents who rate services as good or better.





Since 1985 your Board has approved resolutions authorizing expenditures for residential care facilities serving mentally ill clients. Under the B-1 Administrative Memorandum the selection of providers of residential services for mental health clients is exempt from the Request for Proposals requirement. Behavioral Health and Recovery Services (BHRS) publishes a public notice every year to solicit applications for new providers. BHRS has contracted with Pleasant Care Corporation (“Pleasant Care”) dba Emmanuel Residential since 1998 for the provision of specialized residential board and care services for dually-diagnosed adult clients. On February 12, 2008, the County Manager approved an Agreement with Pleasant Care for these services for the term July 1, 2007 through June 30, 2008, for a maximum obligation of $100,000. That Agreement was for the provision of services for up to twenty beds to mentally ill clients.


When a licensed adult residential facility is sold, the State Department of Social Services holds the licensee responsible for the operation of the facility until such time as the new owner receives its license. On August 8, 2007, Pleasant Care sold Emmanuel Residential to A & C Health Care Services, Inc., (A & C). A & C then provided services under the license of Emmanuel in anticipation of receiving its license from the State. The license for A & C was approved by the State on January 28, 2009.



This Agreement is a direct contract with A & C dba Millbrae Manor for the provision of residential care facility services. A & C will provide services for up to twenty-five San Mateo County clients, with two levels of service, the Step Down Service Level and the Augmented Service Level. Clients at the Step Down Service Level are generally more independent and stable, requiring lower levels of supervision and less intensive services. The Augmented Service Level is for seriously mentally ill clients who require a higher level of supervision and services including more intensive mental health services, social skills training, and assistance with activities of daily living.


A & C Health Care Services, Inc. has recently been in labor negotiations with the staff of a skilled nursing facility which they operate in San Mateo County. BHRS will follow those negotiations and apprise your Board of any concerns about fair labor practices.


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. The contract for these services for this period was initially prepared as an Amendment to the Agreement with Pleasant Care. The Agreement has been delayed due to the extended period of the license completion process.



The term of the Agreement is July 1, 2008 through June 30, 2010. The Agreement maximum is $253,310 for the two-year term. The budgeted maximum for FY 2008-2009 is $126,655, which has been included in the BHRS FY 2008-09 Adopted Budget. Sales tax through realignment will fund $112,723, and Net County Cost is $13,932. A similar arrangement will be in place for FY 2009-10.